Sacroiliac joint nerve ablation with image guidance at Carmel AmbSurg

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

RF ABLATION SI JNT NERVES +IM

Carmel, IN

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How this price compares nationally

Carmel AmbSurg’s median price of $879 is 64% below the median hospital's median price ($2.4k), higher than 13% of the 1,864 hospitals reporting CPT 64625. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 64625 at Carmel AmbSurg

Negotiated rates from the hospital’s own file: 7 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	Anthem 9399_anthem healthsync hmo vein 20250101 fee schedule · outpatient	$184	$184	—	—	—	$184 – $184
2	Anthem 9401_anthem healthsync pos vein 20250101 fee schedule · outpatient	$184	$184	—	—	—	$184 – $184
3	Anthem 9403_anthem hmo pos vein 20250101 fee schedule · outpatient	$184	$184	—	—	—	$184 – $184
4	Anthem 9404_anthem pathway vein 20250101 fee schedule · outpatient	$184	$184	—	—	—	$184 – $184
5	Anthem 9405_anthem pathway x vein 20250101 fee schedule · outpatient	$184	$184	—	—	—	$184 – $184
6	Anthem 9406_anthem preferred vein 20250101 fee schedule · outpatient	$184	$184	—	—	—	$184 – $184
7	Anthem 9407_anthem short term limited duration vein 20250101 fee schedule · outpatient	$184	$184	—	—	—	$184 – $184
8	Anthem 9408_anthem traditional vein 20250101 fee schedule · outpatient	$184	$184	—	—	—	$184 – $184
9	UnitedHealthcare 6575_united health care self funded non-contracted vein 20221002 fee schedule · both	$199	$199	$150	75%	—	$49 – $349
10	UnitedHealthcare 9470_united healthcare vein 20250101 fee schedule · both	$199	$199	$150	75%	—	$49 – $349
11	UnitedHealthcare 6790_united healthcare new business outpatient asin 20230101 fee schedule · outpatient	$226	$226	$170	75%	—	$55 – $396
12	Aetna 8946_aetna medicare replacement asc outpatient asin, ecin, nrin 20241001 fee schedule · outpatient	$879	$879	—	—	—	$879 – $879
13	Aetna 8955_aetna choice medicare replacement asc outpatient asin, ecin, nrin 20241001 fee schedule · outpatient	$879	$879	—	—	—	$879 – $879
14	Ambetter 9036_mhs cenpatico ambetter medicare replacement asc outpatient asin, ecin, nrin 20241001 fee schedule · outpatient	$879	$879	—	—	—	$879 – $879
15	Anthem 8964_anthem medicare replacement asc outpatient asin, ecin, nrin 20241001 fee schedule · outpatient	$879	$879	—	—	—	$879 – $879
16	Caresource 8973_caresource hmo medicare replacement asc outpatient asin, ecin, nrin 20241001 fee schedule · outpatient	$879	$879	—	—	—	$879 – $879
17	Caresource 9054_caresource marketplace medicare replacement asc outpatient asin, ecin, nrin 20241001 fee schedule · outpatient	$879	$879	—	—	—	$879 – $879
18	Humana 8982_humana ppo medicare replacement asc outpatient asin, ecin, nrin 20241001 fee schedule · outpatient	$879	$879	—	—	—	$879 – $879
19	Humana 8991_humana choice medicare replacement asc outpatient asin, ecin, nrin 20241001 fee schedule · outpatient	$879	$879	—	—	—	$879 – $879
20	Humana 9000_humana gold choice medicare replacement asc outpatient asin, ecin, nrin 20241001 fee schedule · outpatient	$879	$879	—	—	—	$879 – $879
21	UnitedHealthcare 9009_united healthcare medicare replacement asc outpatient asin, ecin, nrin 20241001 fee schedule · outpatient	$879	$879	—	—	—	$879 – $879
22	WellCare 9018_wellcare medicare replacement asc outpatient asin, ecin, nrin 20241001 fee schedule · outpatient	$879	$879	—	—	—	$879 – $879
23	Anthem 4090_anthem behavioral medicaid replacement outpatient 20200201 fee schedule · outpatient	$1.0k	$1.0k	—	—	—	$1.0k – $1.0k
24	Anthem 7373_anthem medicaid replacement outpatient 20230101 fee schedule · outpatient	$1.4k	$1.4k	—	—	—	$1.4k – $1.4k
25	Anthem 8255_anthem connect medicaid replacement outpatient 20240101 fee schedule · outpatient	$1.4k	$1.4k	—	—	—	$1.4k – $1.4k

Page 1 of 2 · 38 rates

Last updated: Jan 1, 2026

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