CPT 64654
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
Intl Open Impl BAT Mod System
Low
$543
Average
$35.7k
Median
$32.5k
High
$103.1k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
46 payers; the 90th percentile is 88.1× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare case rate · outpatient · +19 other terms | 163 | $37.9k | $35.4k | $17.9k | 51% | — | $825 – $141.6k |
| 2 | Aetna facility · fee schedule · outpatient · +17 other terms | 90 | $43.9k | $38.3k | $16.3k | 42% | — | $527 – $81.0k |
| 3 | Molina case rate · outpatient · +12 other terms | 56 | $2.6k | $4.9k | $9.8k | 199% | — | $1.9k – $47.2k |
| 4 | Cigna case rate · outpatient · +13 other terms | 53 | $7.5k | $11.9k | $10.2k | 85% | — | $2.4k – $40.7k |
| 5 | Humana facility · fee schedule · outpatient · +15 other terms | 50 | $44.6k | $43.5k | $26.9k | 62% | — | $553 – $223.6k |
| 6 | Blue Cross Blue Shield fee schedule · outpatient · +12 other terms | 46 | $90.6k | $98.9k | $30.4k | 31% | — | $458 – $150.3k |
| 7 | Superior Healthplan case rate · outpatient · +1 other terms | 33 | $948 | $944 | $8 | 1% | — | $929 – $948 |
| 8 | Kaiser fee schedule · outpatient · +6 other terms | 30 | $68.6k | $98.6k | $74.6k | 76% | — | $44.1k – $353.9k |
| 9 | Devoted facility · fee schedule · outpatient · +5 other terms | 27 | $41.7k | $44.3k | $3.7k | 8% | — | $41.7k – $50.6k |
| 10 | Anthem facility · fee schedule · outpatient · +12 other terms | 24 | $41.7k | $42.0k | $37.7k | 90% | — | $528 – $154.3k |
| 11 | WellCare fee schedule · outpatient · +8 other terms | 23 | $52.9k | $53.0k | $3.1k | 6% | — | $47.8k – $58.9k |
| 12 | Ambetter facility · fee schedule · outpatient · +3 other terms | 21 | $75.0k | $75.1k | $13.8k | 18% | — | $50.0k – $95.1k |
| 13 | Medicare fee schedule · outpatient · +5 other terms | 18 | $44.1k | $44.1k | — | — | — | $44.1k – $44.1k |
| 14 | Caresource facility · case rate · outpatient · +5 other terms | 17 | $18.8k | $32.0k | $27.1k | 85% | — | $16.0k – $90.0k |
| 15 | Regence facility · fee schedule · outpatient · +5 other terms | 15 | $46.4k | $46.7k | $1.3k | 3% | — | $44.6k – $50.6k |
| 16 | Medical Mutual facility · fee schedule · outpatient · +4 other terms | 13 | $42.1k | $50.4k | $10.3k | 20% | — | $41.7k – $65.8k |
| 17 | Optum fee schedule · outpatient · +6 other terms | 13 | $44.1k | $65.6k | $42.8k | 65% | — | $44.1k – $162.6k |
| 18 | First Health per diem · outpatient · +7 other terms | 11 | $365 | $365 | — | — | — | $365 – $365 |
| 19 | Medica case rate · outpatient · +10 other terms | 9 | $2.8k | $2.8k | $47 | 2% | — | $2.8k – $2.9k |
| 20 | Oscar case rate · outpatient · +8 other terms | 9 | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 21 | Tricare facility · fee schedule · outpatient · +3 other terms | 8 | $24.0k | $25.3k | $24.5k | 97% | — | $474 – $52.0k |
| 22 | Aetna Better Health facility · fee schedule · outpatient · +5 other terms | 7 | $24.0k | $21.1k | $4.8k | 23% | — | $13.6k – $24.7k |
| 23 | Amerihealth Caritas facility · case rate · outpatient · +3 other terms | 6 | $13.3k | $13.3k | — | — | — | $13.3k – $13.3k |
| 24 | Excellus fee schedule · outpatient · +6 other terms | 6 | $92.2k | $93.4k | $27.6k | 30% | — | $58.9k – $151.8k |
| 25 | Highmark fee schedule · outpatient · +9 other terms | 6 | $55.0k | $69.5k | $36.9k | 53% | — | $587 – $129.1k |
← Hospitals reporting CPT 64654 · Snapshot 20261113T090226Z-3ce6c0b8