CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Ann & Robert H Lurie Childrens Hospital of Chicago

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $140
  • Cash Discount Price: $123
  • vs. Medicare Baseline: 0.63x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Ann & Robert H Lurie Childrens Hospital of Chicago is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.63x the Medicare baseline. Located in 225 E Chicago Ave, Box 140, Chicago, IL.
Cash / Self-Pay
$123

Average discount available for prompt cash payment at this facility.

Insurance Median
$140

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: $123 (55%)
Insurance Median: $140 (63%)
Cash: $123 (55% of Medicare)
Ins. Median: $140 (63% 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
Medicare (plans) $30 - $2,656 13%
Mercycare Health $65 29%
Cigna $74 - $124 33%
Blue Cross Blue Shield $76 - $140 34%
Aetna $88 - $137 39%
Beacon Health Options $88 39%
La Rabida Childrens Hospital $88 39%
UnitedHealthcare $101 - $108 45%
Centegra $105 47%
Independent Physicians At Mercy $105 47%
Advanced Physicians Association Ipa $122 55%
Health Plus $122 55%
Imagine Health $122 55%
Methodist First Choice $122 55%
Northwest Community Healthcare $122 55%
Presence Health Partners $122 55%
St. Francis $122 55%
Ui Health $122 55%
West Suburban Health Providers $122 55%
Shriners Hospital $131 59%
Swedish Covenant Physician Partners $131 59%
American Psych Systems $140 63%
Health Alliance $140 63%
Macneal Health $140 63%
Magellan $140 - $900 63%
Healthlink Inc. $144 64%
Cofinity $149 67%
Hfn Inc $149 - $158 67%
Humana $149 67%
Principal Healthcare $149 67%
St. Elizabeth $149 67%
First Health $154 69%
Healthstar $154 69%
Preferred Health Network $154 69%
Sagamore Health Network $154 69%
Beech Street $158 71%
Benchmark Health $158 71%
Employer'S Coalition On Health $158 71%
Private Health Care System $158 71%
Security Health Plan $158 71%
Swedish American $158 71%
Wellmark/Healthnetwork $161 72%
Health Smart $166 74%
Integrated Health Plan $166 74%
Multiplan $166 74%
National Provider Network $166 74%
Wea Insurance Group $166 74%
Unicare $3,678 - $8,500 1644%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 E Chicago Ave, Box 140, Chicago, IL 60611
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens