Nerve block injection to trigeminal nerve at Ascension Seton

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

NJX AA&/STRD TRIGEMINAL NRV

Kyle, TX

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How this price compares nationally

Ascension Seton’s median price of $280 is 29% below the median hospital's median price ($395), higher than 19% of the 2,360 hospitals reporting CPT 64400. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 64400 at Ascension Seton

Negotiated rates from the hospital’s own file: 9 payers, 39 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 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient	$55	$55	—	—	—	$55 – $55
2	Blue Cross Blue Shield 3696_chirp blue cross star (hay) inpatient 20240901 fee schedule · both	$58	$58	—	—	—	$58 – $58
3	Blue Cross Blue Shield 4222_chirp blue cross star (hay) outpatient 20241201 fee schedule · both	$58	$58	—	—	—	$58 – $58
4	UnitedHealthcare 3740_chirp uhc star (hay) inpatient 20240901 fee schedule · both	$58	$58	—	—	—	$58 – $58
5	UnitedHealthcare 3751_chirp uhc star plus (hay) inpatient 20240901 fee schedule · both	$58	$58	—	—	—	$58 – $58
6	UnitedHealthcare 4256_chirp uhc star (hay) outpatient 20241201 fee schedule · both	$58	$58	—	—	—	$58 – $58
7	UnitedHealthcare 4267_chirp uhc star plus (hay) outpatient 20241201 fee schedule · both	$58	$58	—	—	—	$58 – $58
8	UnitedHealthcare 4314_uhc star kids (hay) outpatient 20241201 fee schedule · both	$58	$58	—	—	—	$58 – $58
9	UnitedHealthcare 4325_uhc star kids (hay) inpatient 20240901 fee schedule · both	$58	$58	—	—	—	$58 – $58
10	Blue Cross Blue Shield 4168_blue cross chip (chi,dcn) outpatient 20241201 fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
11	Blue Cross Blue Shield 4168_blue cross chip/star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
12	Blue Cross Blue Shield 4171_blue cross chip (hay) outpatient 20241201 fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
13	Blue Cross Blue Shield 4171_blue cross chip/star kids (hay) outpatient 20241201 fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
14	Blue Cross Blue Shield 4219_chirp blue cross star (chi,dcn) outpatient 20241201 fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
15	Blue Cross Blue Shield 5003_blue cross star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
16	Blue Cross Blue Shield 5009_blue cross star kids (hay) outpatient 20241201 fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
17	UnitedHealthcare 4253_chirp uhc star (chi,dcn) outpatient 20241201 fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
18	UnitedHealthcare 4264_chirp uhc star plus (chi,dcn) outpatient 20241201 fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
19	UnitedHealthcare 4311_uhc star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
20	Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient	$73	$73	—	—	—	$73 – $73
21	Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient	$73	$73	—	—	—	$73 – $73
22	Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient	$79	$79	—	—	—	$79 – $79
23	Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient	$90	$90	—	—	—	$90 – $90
24	Tricare 1229_tricare cah outpatient 20170101 fee schedule · outpatient	$216	$216	—	—	—	$216 – $216
25	Aetna 4659_medicare advantage aetna inpatient 20251001 other · inpatient	$286	$286	—	—	—	$286 – $286

Page 1 of 2 · 39 rates

Last updated: Jan 1, 2026

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