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
CHEMODENERV 1 EXTREMITY 1-4
Austin, TX
See all hospitals reporting CPT 64642 →Price type
Ascension Seton’s median price of $338 is 58% below the median hospital's median price ($796), higher than 16% of the 1,943 hospitals reporting CPT 64642. 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, 38 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 3697_chirp blue cross star (nw) inpatient 20240901 fee schedule · both | $37 | $37 | — | — | — | $37 – $37 |
| 2 | Blue Cross Blue Shield 4223_chirp blue cross star (nw) outpatient 20241201 fee schedule · both | $37 | $37 | — | — | — | $37 – $37 |
| 3 | UnitedHealthcare 3741_chirp uhc star (nw) inpatient 20240901 fee schedule · both | $39 | $39 | — | — | — | $39 – $39 |
| 4 | UnitedHealthcare 3752_chirp uhc star plus (nw) inpatient 20240901 fee schedule · both | $39 | $39 | — | — | — | $39 – $39 |
| 5 | UnitedHealthcare 4257_chirp uhc star (nw) outpatient 20241201 fee schedule · both | $39 | $39 | — | — | — | $39 – $39 |
| 6 | UnitedHealthcare 4268_chirp uhc star plus (nw) outpatient 20241201 fee schedule · both | $39 | $39 | — | — | — | $39 – $39 |
| 7 | UnitedHealthcare 4315_uhc star kids (nw) outpatient 20241201 fee schedule · both | $39 | $39 | — | — | — | $39 – $39 |
| 8 | UnitedHealthcare 4326_uhc star kids (nw) inpatient 20240901 fee schedule · both | $39 | $39 | — | — | — | $39 – $39 |
| 9 | Blue Cross Blue Shield 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient | $57 | $57 | — | — | — | $57 – $57 |
| 10 | Blue Cross Blue Shield 4168_blue cross chip (chi,dcn) outpatient 20241201 fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 11 | Blue Cross Blue Shield 4168_blue cross chip/star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 12 | Blue Cross Blue Shield 4172_blue cross chip (nw) outpatient 20241201 fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 13 | Blue Cross Blue Shield 4172_blue cross chip/star kids (nw) outpatient 20241201 fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 14 | Blue Cross Blue Shield 4219_chirp blue cross star (chi,dcn) outpatient 20241201 fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 15 | Blue Cross Blue Shield 5003_blue cross star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 16 | Blue Cross Blue Shield 5011_blue cross star kids (nw) outpatient 20241201 fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 17 | UnitedHealthcare 4253_chirp uhc star (chi,dcn) outpatient 20241201 fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 18 | UnitedHealthcare 4264_chirp uhc star plus (chi,dcn) outpatient 20241201 fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 19 | UnitedHealthcare 4311_uhc star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 20 | Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient | $76 | $76 | — | — | — | $76 – $76 |
| 21 | Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient | $76 | $76 | — | — | — | $76 – $76 |
| 22 | Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $81 | $81 | — | — | — | $81 – $81 |
| 23 | Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient | $92 | $92 | — | — | — | $92 – $92 |
| 24 | Tricare 1229_tricare cah outpatient 20170101 fee schedule · outpatient | $565 | $565 | — | — | — | $565 – $565 |
| 25 | Aetna 4659_medicare advantage aetna inpatient 20251001 other · inpatient | $671 | $671 | — | — | — | $671 – $671 |
Last updated: Jan 1, 2026
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