CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Deaconess Illinois Crossroads

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $212
  • Cash Discount Price: $89
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Deaconess Illinois Crossroads is $212. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.95x the Medicare baseline. Located in 8 Doctors Park Rd, Mount Vernon, IL.
Cash / Self-Pay
$89

Average discount available for prompt cash payment at this facility.

Insurance Median
$212

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: $89 (40%)
Insurance Median: $212 (95%)
Cash: $89 (40% of Medicare)
Ins. Median: $212 (95% 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.

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 $7 - $318 3%
Blue Cross Blue Shield $7 - $212 3%
Humana $7 - $314 3%
Meridian Health Plan $7 - $212 3%
Molina Healthcare Of Illinois $7 - $214 3%
Mytru Advantage $7 - $212 3%
Umwa $7 - $212 3%
UnitedHealthcare $7 - $234 3%
Wellcare $7 - $212 3%
Alliance Coal $10 - $350 4%
Deaconess Onecare $11 - $222 5%
Alter-Net Medical Services, Inc. $12 - $604 5%
Noncontracted $12 - $339 5%
Self-Pay $18 - $89 8%
Cigna $20 - $157 9%
Prime Health Services $39 - $302 17%
Guardian Resources, Inc. $44 - $339 20%
Healthcare'S Finest Network (Hfn) $44 - $343 20%
Medicalcontrol Network Solutions $44 - $343 20%
National Provider Network $44 - $343 20%
Three Rivers Provider Network $45 - $351 20%
Beech Street $46 - $355 21%
Hope Trust $141 - $604 63%
Wexford Health Sources $181 - $282 81%
Care Improvement Plus $216 97%
Encore Prime/Elite/Elite + $221 - $229 99%
Encore Combined $246 - $254 110%
Great West Healthcare Of Illinois $302 135%
Multiplan - Primary Network - Phcs $316 141%
Healthlink $323 - $343 144%
Coventry Healthcare $339 152%
First Health $339 152%
Multiplan - Complementary Network $344 154%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8 Doctors Park Rd, Mount Vernon, IL 62864
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals