CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: OSF Little Company of Mary Medical Center

Billing Code: 94640 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$227

about 1.0× the $224 Medicare rate · typically $91–$267

modeled estimate · not a bill or quote

Medicare pays $224 Fair price $227 Cash price $102 Hospital's list price $170

How we calculate the fair BaseRate →

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser 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
Blue Cross Blue Shieldmajor	$436	195%
Aetnamajor	$239	107%
Molina	$329	147%
WellCare	$237	106%
+ 2 smaller / regional plans	$235 - $282

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 102), 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 OSF Little Company of Mary 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 OSF Little Company of Mary Medical Center

Compare: Breathing treatment (nebulizer) at other IL hospitals

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