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
TRML DSTRJ IOS BVN EA ADDL
Summit, WI
See all hospitals reporting CPT 64629 →Price type
Aurora Medical Center Summit’s median price of $1.8k is 1% below the median hospital's median price ($1.8k), higher than 48% of the 1,260 hospitals reporting CPT 64629. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 3 payers, 6 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 | UnitedHealthcare exchange case rate · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 2 | UnitedHealthcare charter case rate · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 3 | UnitedHealthcare nexus case rate · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 4 | UnitedHealthcare hmo case rate · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 5 | Molina commercial case rate · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 6 | Aetna hmo case rate · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
Last updated: Nov 21, 2025
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