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
FACET DEST NRV LUMB ADDL W/IG
Arlington, TX
See all hospitals reporting CPT 64636 →Price type
AMH Cath Labs LLC’s median price of $1.2k is about the same as the median hospital's median price ($1.2k), higher than 49% of the 1,926 hospitals reporting CPT 64636. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 27 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $233 | $233 | — | — | — | $233 – $233 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $233 | $233 | — | — | — | $233 – $233 |
| 3 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $240 | $240 | — | — | — | $240 – $240 |
| 4 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $245 | $245 | — | — | — | $245 – $245 |
| 5 | Humana medicare advantage case rate · outpatient | $250 | $250 | — | — | — | $250 – $250 |
| 6 | Humana medicare advantage ppo case rate · outpatient | $250 | $250 | — | — | — | $250 – $250 |
| 7 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $251 | $251 | — | — | — | $251 – $251 |
| 8 | Molina medicare advantage case rate · outpatient | $252 | $252 | — | — | — | $252 – $252 |
| 9 | WellCare medicare advantage hmo case rate · outpatient | $252 | $252 | — | — | — | $252 – $252 |
| 10 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $256 | $256 | — | — | — | $256 – $256 |
| 11 | WellCare medicare advantage mmp case rate · outpatient | $264 | $264 | — | — | — | $264 – $264 |
| 12 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $267 | $267 | — | — | — | $267 – $267 |
| 13 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $272 | $272 | — | — | — | $272 – $272 |
| 14 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 15 | UnitedHealthcare all payer case rate · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 16 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 17 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 18 | UnitedHealthcare ppo case rate · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 19 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 20 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 21 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 22 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 23 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 24 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 25 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
Last updated: Apr 21, 2026
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