CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: St Alexius Medical Center

Billing Code: 94640 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$262

about 1.2× the $224 Medicare rate · typically $90–$262

modeled estimate · not a bill or quote

What this hospital charges insurers

$214

Below the fair price — a good deal

about $48 under the fair price · 1.0× Medicare

Medicare pays $224 Fair price $262 This hospital $214

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 $214

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 $262 (about 1.2× the $224 Medicare rate). St Alexius Medical Center charges insurers about $214 — below the fair price — a good deal. Located in Hoffman Estates, 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	$201 - $214	90%
Blue Cross Blue Shieldmajor	$59 - $375	26%
Aetnamajor	$59 - $223	26%
Cignamajor	$56 - $230	25%
Humanamajor	$212	95%
Ambetter (Centene)	$343	153%
Bright Health	$265	118%
Meridian	$59	26%
Molina	$218	97%
+ 6 smaller / regional plans	$59 - $329

Government programs also on file: Medicare, Medicaid.

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, 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 St Alexius 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 St Alexius Medical Center

Compare: Breathing treatment (nebulizer) at other IL hospitals

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