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
$671
Average
$76.8k
Median
$83.0k
High
$124.2k
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
42 hospitals; the 90th percentile is 2.0× 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.
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42 hospital rates
iThe hospitals that file a Ambetter 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 | Baylor Scott & White Heart and Vascular Hospital - Dallas Dallas, TX facility · fee schedule · outpatient | 1 | $95.1k | $95.1k | — | — | — | $95.1k – $95.1k |
| 2 | Baylor Scott & White The Heart Hospital - Plano Plano, TX facility · fee schedule · outpatient | 1 | $95.1k | $95.1k | — | — | — | $95.1k – $95.1k |
| 3 | Bradley Medical Center Cleveland, TN facility · fee schedule · outpatient | 1 | $68.6k | $68.6k | — | — | — | $68.6k – $68.6k |
| 4 | CRAWFORD LONG HOSPITAL Atlanta, GA facility · fee schedule · outpatient | 1 | $94.8k | $94.8k | — | — | — | $94.8k – $94.8k |
| 5 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 1 | $100.8k | $100.8k | — | — | — | $100.8k – $100.8k |
| 6 | HSA CGH LLC Coral Gables, FL facility · fee schedule · outpatient | 1 | $85.1k | $85.1k | — | — | — | $85.1k – $85.1k |
| 7 | HSA PGH LLC Hialeah, FL facility · fee schedule · outpatient | 1 | $85.1k | $85.1k | — | — | — | $85.1k – $85.1k |
| 8 | Hendrick Medical Center Brownwood, TX facility · case rate · outpatient | 1 | $100.4k | $100.4k | — | — | — | $100.4k – $100.4k |
| 9 | Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $66.7k | $66.7k | — | — | — | $66.7k – $66.7k |
| 10 | Inspira Medical Center Mullica Hill Hill, NJ fee schedule · outpatient | 1 | $101.6k | $101.6k | — | — | — | $101.6k – $101.6k |
| 11 | Inspira Medical Center Vineland Vineland, NJ fee schedule · outpatient | 1 | $101.6k | $101.6k | — | — | — | $101.6k – $101.6k |
| 12 | Lakewood Medical Center Kansas City, MO facility · fee schedule · outpatient | 1 | $50.0k | $50.0k | — | — | — | $50.0k – $50.0k |
| 13 | MISSION HOSPITAL Arden, NC case rate · outpatient | 1 | $10.1k | $10.1k | — | — | — | $10.1k – $10.1k |
| 14 | MISSION HOSPITAL MCDOWELL Marion, NC case rate · outpatient | 1 | $10.1k | $10.1k | — | — | — | $10.1k – $10.1k |
| 15 | MultiCare Auburn Medical Center Auburn, WA fee schedule · outpatient | 1 | $100.3k | $100.3k | — | — | — | $100.3k – $100.3k |
| 16 | MultiCare Capital Medical Center Lacey, WA fee schedule · outpatient | 1 | $92.5k | $92.5k | — | — | — | $92.5k – $92.5k |
| 17 | MultiCare Covington Medical Center Covington, WA fee schedule · outpatient | 1 | $100.3k | $100.3k | — | — | — | $100.3k – $100.3k |
| 18 | MultiCare Deaconess Hospital Spokane, WA fee schedule · outpatient | 1 | $89.0k | $89.0k | — | — | — | $89.0k – $89.0k |
| 19 | MultiCare Valley Hospital Spokane Valley, WA fee schedule · outpatient | 1 | $89.0k | $89.0k | — | — | — | $89.0k – $89.0k |
| 20 | MultiCare Yakima Valley Memorial Hospital Association Union Gap, WA fee schedule · outpatient | 1 | $88.1k | $88.1k | — | — | — | $88.1k – $88.1k |
| 21 | Naples Community Hospital Naples, FL fee schedule · outpatient | 1 | $103.5k | $103.5k | — | — | — | $103.5k – $103.5k |
| 22 | New Liberty Hospital Corporation Liberty, MO facility · fee schedule · outpatient | 1 | $56.0k | $56.0k | — | — | — | $56.0k – $56.0k |
| 23 | OHI West, Inc. Pinellas Park, FL fee schedule · outpatient | 1 | $87.4k | $87.4k | — | — | — | $87.4k – $87.4k |
| 24 | SID Peterson Memorial Hospital Kerrville, TX facility · case rate · outpatient | 1 | $53.1k | $53.1k | — | — | — | $53.1k – $53.1k |
| 25 | Sarasota Memorial Hospital Sarasota, FL fee schedule · outpatient | 1 | $124.2k | $124.2k | — | — | — | $124.2k – $124.2k |
← Payers reporting CPT 64654 · Snapshot 20261113T090226Z-3ce6c0b8