CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Northwestern Medicine Kishwaukee Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $88
Cash Discount Price: $91
vs. Medicare Baseline: 0.39x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Northwestern Medicine Kishwaukee Hospital is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.39x the Medicare baseline. Located in One Kish Hospital Drive, Dekalb, IL.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $91 (41%)

Insurance Median: $88 (39%)

Cash: $91 (41% of Medicare)

Ins. Median: $88 (39% 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	$24 - $112	11%
Health'S Finest Network [126]	$58 - $120	26%
UnitedHealthcare	$65 - $130	29%
Cigna	$69	31%
Blue Cross Blue Shield	$73 - $130	33%
The Alliance [1703]	$84	38%
Choicecare [177]	$98	44%
Healthlink [125]	$98	44%
Multiplan/Phcs [142]	$101 - $130	45%
Coventry [1218]	$112	50%
Coventryone Ppo [17110]	$112	50%
First Health Plan [6034]	$112	50%

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 $91.
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 Northwestern Medicine Kishwaukee 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.