CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Presence Mercy Medical Center

Billing Code: 94640 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$242

about 1.1× the $224 Medicare rate · typically $71–$242

modeled estimate · not a bill or quote

What this hospital charges insurers

$234

About the fair price

about $8 under the fair price · 1.0× Medicare

Medicare pays $224 Fair price $242 This hospital $234 Cash price $233 Hospital's list price $395

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

Highest price of the 9 IL hospitals we have prices for — worth calling around.

Cheapest $22 Priciest $234

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

A fair price for a Breathing treatment (nebulizer) is about $242 (about 1.1× the $224 Medicare rate). Presence Mercy Medical Center charges insurers about $234, or about $233 in cash — about the fair price. Located in Aurora, IL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$234 - $395	105%
Blue Cross Blue Shieldmajor	$72 - $327	32%
Aetnamajor	$72 - $245	32%
Cignamajor	$234	105%
Humanamajor	$72 - $257	32%
Ambetter (Centene)	$378	169%
Devoted Health	$234	105%
Health Net	$280	125%
HealthPartners	$234 - $269	105%
Meridian	$76 - $245	34%
Molina	$76 - $350	34%
WellCare	$234	105%
+ 10 smaller / regional plans	$9 - $362

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 233), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 94640.

Insurance Before you use insurance

Call your insurance company to confirm Presence Mercy Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 94640.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Presence Mercy Medical Center

Compare: Breathing treatment (nebulizer) at other IL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.