Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HB Njx Dx/Ther Agt Pvrt Facet Jt Crv/Thrc 3+ Level
Low
$102
Average
$643
Median
$380
High
$6.6k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
55 hospitals; the 90th percentile is 11.7× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
84 hospital rates
iThe hospitals that file a Wellmark rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Pella Regional Health Center Pella, IA other · outpatient | 2 | $917 | $917 | $216 | 24% | 18–180 | $701 – $1.1k |
| 2 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 2 | $305 | $305 | — | — | — | $305 – $305 |
| 3 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · inpatient | 2 | $290 | $290 | — | — | — | $290 – $290 |
| 4 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 4 | $115 | $105 | $30 | 28% | — | $55 – $135 |
| 5 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · inpatientfrom % of charges | 1 | $680 | $680 | — | — | — | $680 – $680 |
| 6 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $680 | $680 | — | — | — | $680 – $680 |
| 7 | Avera Holy Family Hospital Estherville, IA fee schedule · both | 2 | $125 | $125 | $10 | 8% | — | $115 – $135 |
| 8 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · bothfrom % of charges | 1 | $499 | $499 | — | — | — | $499 – $499 |
| 9 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 4 | $115 | $105 | $30 | 28% | — | $55 – $135 |
| 10 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 4 | $115 | $105 | $30 | 28% | — | $55 – $135 |
| 11 | Floyd Valley Healthcare Le Mars, IA fee schedule · both | 2 | $125 | $125 | $10 | 8% | — | $115 – $135 |
| 12 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 4 | $115 | $105 | $30 | 28% | — | $55 – $135 |
| 13 | Grundy County Memorial Hospital Grundy Center, IA facility · percent of total billed charges · inpatientfrom % of charges | 2 | $642 | $642 | $91 | 14% | — | $551 – $733 |
| 14 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · outpatient | 2 | $1.8k | $1.8k | $86 | 5% | — | $1.8k – $1.9k |
| 15 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1.9k | $1.9k | $18 | 1% | — | $1.9k – $1.9k |
| 16 | HAWARDEN REGIONAL HEALTHCARE HARWARDEN, IA other · outpatient | 2 | $378 | $378 | $151 | 40% | — | $227 – $530 |
| 17 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $118 | $133 | $26 | 19% | — | $118 – $177 |
| 18 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 2 | $94 | $100 | $32 | 32% | — | $53 – $140 |
| 19 | Johnson Memorial Hospital Stafford Springs, CT facility · case rate · both | 1 | $6.6k | $6.6k | — | — | — | $6.6k – $6.6k |
| 20 | Johnson Memorial Hospital Stafford Springs, CT facility · case rate · outpatient | 1 | $6.6k | $6.6k | — | — | — | $6.6k – $6.6k |
| 21 | Mercy Fitzgerald Hospital Darby, PA facility · fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 22 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $390 | $390 | — | — | — | $390 – $390 |
| 23 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $397 | $397 | — | — | — | $397 – $397 |
| 24 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · case rate · inpatient | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 25 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · case rate · outpatient | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
← Payers reporting CPT 64492 · Snapshot 20261112T124536Z-e251e855