CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Fhn Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $197
Cash Discount Price: $202
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Fhn Memorial Hospital is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.88x the Medicare baseline. Located in 1045 West Stephenson Street, Freeport, IL.

Cash / Self-Pay

$202

Average discount available for prompt cash payment at this facility.

Insurance Median

$197

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$223.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $223.72 (100%)

Cash / Self-Pay: $202 (90%)

Insurance Median: $197 (88%)

Cash: $202 (90% of Medicare)

Ins. Median: $197 (88% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $223.72 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

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
Aetna	$42 - $235	19%
The Alliance - All Plans	$46 - $152	21%
Ecoh Nihp	$48 - $159	21%
Nihp Employ - All Plans	$48 - $159	21%
Quartz - All Other Plans	$49 - $164	22%
Meridian Health Plan - All Plans	$50	22%
Blue Cross Blue Shield	$51 - $171	23%
Ecoh - All Other Plans	$52 - $172	23%
Northern Il Hp - All Plans	$52 - $174	23%
First Health - All Plans	$53 - $178	24%
UnitedHealthcare	$59 - $237	26%
Humana	$60 - $235	27%
Hfn - All Plans	$62 - $207	28%
First Choice Il - All Plans	$65 - $215	29%
Multiplan Phcs - All Plans	$65 - $215	29%
Wps - All Plans	$66 - $221	30%
Galaxy - All Plans	$68 - $228	30%
Health Alliance - All Other Plans	$68 - $228	30%
Interplan Health - All Plans	$68 - $228	30%
Preferred Plan Ppo - All Plans	$68 - $228	30%
Trustmark - All Plans	$70 - $233	31%
Midland Choice - All Plans	$72 - $240	32%
Osf Healthplans - All Plans	$76 - $253	34%
Health Alliance Mcr Adv	$235	105%
Quartz Mcr Adv	$235	105%

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 $202.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fhn Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
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.