CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Franciscan Health Olympia & Chicago Heights

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $110
Cash Discount Price: $54
vs. Medicare Baseline: 0.49x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Franciscan Health Olympia & Chicago Heights is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.49x the Medicare baseline. Located in 20201 S Crawford Avenue, Olympia Fields, IL.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$110

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: $54 (24%)

Insurance Median: $110 (49%)

Cash: $54 (24% of Medicare)

Ins. Median: $110 (49% 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
Managed Health Services [1302]	$7	3%
Mdwise [1175]	$7	3%
Medicaid / KanCare	$7	3%
Blue Cross Blue Shield	$33 - $560	15%
Cigna	$59 - $163	26%
Commercial [2001]	$86 - $206	38%
Managed Care [2000]	$86 - $206	38%
United Medical Resources [1158]	$86 - $178	38%
United Medical Resources [1301]	$86 - $178	38%
UnitedHealthcare	$86 - $178	38%
Great West Insurance [1055]	$88 - $163	39%
Medicare (plans)	$171 - $317	76%
Workers Comp [1172]	$469	210%

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 $54.
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 Franciscan Health Olympia & Chicago Heights 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.