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
HC INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, ADD LEVEL
Boulder, CO
See all hospitals reporting CPT 64495 →Price type
Boulder Community Health’s median price of $105 is 87% below the median hospital's median price ($807), higher than 14% of the 1,976 hospitals reporting CPT 64495. 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, 40 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 | Aetna medicare advantage professional · case rate · both | $46 | $46 | — | — | — | $46 – $46 |
| 2 | Anthem medicare advantage professional · fee schedule · both | $46 | $46 | — | — | — | $46 – $46 |
| 3 | Devoted medicare advantage professional · fee schedule · both | $46 | $46 | — | — | — | $46 – $46 |
| 4 | Humana medicare advantage professional · fee schedule · both | $46 | $46 | — | — | — | $46 – $46 |
| 5 | Anthem managed care facility · fee schedule · outpatient | $51 | $51 | — | — | — | $51 – $51 |
| 6 | Kaiser medicare advantage professional · fee schedule · both | $56 | $56 | — | — | — | $56 – $56 |
| 7 | Anthem commercial facility · fee schedule · outpatient | $50 | $63 | $31 | 49% | — | $44 – $131 |
| 8 | Anthem commercial professional · fee schedule · both | $64 | $70 | $10 | 14% | — | $64 – $86 |
| 9 | Kaiser commercial professional · fee schedule · both | $72 | $72 | — | — | — | $72 – $72 |
| 10 | UnitedHealthcare medicare advantage professional · fee schedule · both | $74 | $74 | $29 | 39% | — | $46 – $103 |
| 11 | MultiPlan commercial professional · fee schedule · both | $79 | $79 | — | — | — | $79 – $79 |
| 12 | Phcs commercial professional · fee schedule · both | $79 | $79 | — | — | — | $79 – $79 |
| 13 | Cigna commercial professional · percent of total billed charges · bothfrom % of charges | $82 | $82 | — | — | — | $82 – $82 |
| 14 | Cigna commercial facility · fee schedule · outpatient | $83 | $83 | — | — | — | $83 – $83 |
| 15 | Anthem managed care professional · fee schedule · both | $86 | $86 | — | — | — | $86 – $86 |
| 16 | Cigna commercial professional · fee schedule · both | $86 | $86 | — | — | — | $86 – $86 |
| 17 | Aetna medicare advantage facility · case rate · outpatient | $103 | $103 | — | — | — | $103 – $103 |
| 18 | Anthem medicare advantage facility · case rate · outpatient | $103 | $103 | — | — | — | $103 – $103 |
| 19 | Aetna commercial professional · fee schedule · both | $103 | $103 | — | — | — | $103 – $103 |
| 20 | Aetna ppo professional · fee schedule · both | $103 | $103 | — | — | — | $103 – $103 |
| 21 | UnitedHealthcare commercial professional · fee schedule · both | $105 | $105 | — | — | — | $105 – $105 |
| 22 | Humana medicare advantage facility · case rate · outpatient | $105 | $105 | — | — | — | $105 – $105 |
| 23 | UnitedHealthcare medicare advantage facility · case rate · outpatient | $105 | $105 | — | — | — | $105 – $105 |
| 24 | Kaiser medicare advantage facility · case rate · outpatient | $105 | $105 | $1 | 0% | — | $105 – $106 |
| 25 | Devoted medicare advantage facility · case rate · outpatient | $106 | $106 | — | — | — | $106 – $106 |
Last updated: Sep 16, 2026
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