CMS Price Transparency Data

Community mental health services

Facility: Memorial Hospital Miramar

Billing Code: H0038 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: H0038
Insurance Median: $15
Cash Discount Price: $18
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Community mental health services at Memorial Hospital Miramar is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1901 Sw 172Nd Ave, Miramar, FL.

Cash / Self-Pay

$18

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Cigna	$1 - $12	N/A
Community Care Plan	$1 - $4	N/A
Aetna	$1 - $6	N/A
Amerihealth Caritas	$1 - $4	N/A
Avmed	$1 - $8	N/A
Molina	$1 - $4	N/A
Employers Health Network	$2 - $8	N/A
Sunshine	$3 - $10	N/A
Global Medical Management	$4 - $74	N/A
Health Sun	$4 - $19	N/A
Quebec Inc	$4 - $74	N/A
Plotkin	$4 - $74	N/A
Allianz	$4 - $74	N/A
Quality Health Management	$4 - $72	N/A
Star Healthcare Network	$4 - $74	N/A
Worldwide Managed Care Partners	$4 - $74	N/A
Desjardins Financial Security Life Assurance Company	$4 - $74	N/A
Dimension Health	$4 - $17	N/A
National Healthcare Solutions	$4 - $74	N/A
Axis	$4 - $74	N/A
Emerging Therapy Solutions	$4 - $70	N/A
Worldwide Medical Assurance	$4 - $74	N/A
Global Health Claims	$4 - $79	N/A
Global Reach Health	$4 - $74	N/A
World Medical Care	$4 - $16	N/A
Evernorth	$5 - $20	N/A
Employers Choice Network	$5 - $74	N/A
Gallagher Bassett	$5 - $20	N/A
Florida Community Care	$13 - $60	N/A
Carelon	$205	N/A
Broward County	$718 - $2,726	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $18.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: H0038.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Memorial Hospital Miramar is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code H0038.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.