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 CHEM/DEST FACIAL NERVE MUSCLE
Princeton, IN
See all hospitals reporting CPT 64612 →Price type
Deaconess Health System Gibson General Hospital’s median price of $203 is 48% below the median hospital's median price ($393), higher than 13% of the 1,913 hospitals reporting CPT 64612. 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, 36 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 | Bcbs Il managed medicaid professional · fee schedule · both | $81.33 | $81.33 | $81.33 – $81.33 |
| 2 | WellCare managed medicaid professional · fee schedule · both | $81.33 | $81.33 | $81.33 – $81.33 |
| 3 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $103.50 | $103.50 | $103.50 – $103.50 |
| 4 | Aetna medicare advantage professional · fee schedule · both | $106.82 | $106.82 | $106.82 – $106.82 |
| 5 | Anthem medicare advantage professional · fee schedule · both | $106.82 | $106.82 | $106.82 – $106.82 |
| 6 | Bcbs Il medicare advantage professional · fee schedule · both | $106.82 | $106.82 | $106.82 – $106.82 |
| 7 | UnitedHealthcare medicare advantage professional · fee schedule · both | $106.82 | $106.82 | $106.82 – $106.82 |
| 8 | WellCare dual medicare/medicaid professional · fee schedule · both | $106.82 | $106.82 | $106.82 – $106.82 |
| 9 | WellCare medicare advantage professional · fee schedule · both | $106.82 | $106.82 | $106.82 – $106.82 |
| 10 | Anthem commercial professional · fee schedule · both | $110.55 | $109.31 | $106.82 – $110.55 |
| 11 | Caresource commercial professional · fee schedule · both | $122.85 | $122.85 | $106.82 – $138.87 |
| 12 | Anthem managed medicaid professional · fee schedule · both | $124.90 | $124.90 | $124.90 – $124.90 |
| 13 | Caresource managed medicaid professional · fee schedule · both | $124.90 | $124.90 | $124.90 – $124.90 |
| 14 | UnitedHealthcare managed medicaid professional · fee schedule · both | $124.90 | $124.90 | $124.90 – $124.90 |
| 15 | Ambetter commercial facility · percent of total billed charges · outpatientfrom % of charges | $132.48 | $132.48 | $132.48 – $132.48 |
| 16 | Anthem commercial facility · percent of total billed charges · outpatientfrom % of charges | $132.48 | $132.48 | $132.48 – $132.48 |
| 17 | Anthem medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $132.48 | $132.48 | $132.48 – $132.48 |
| 18 | Bcbs Il medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $132.48 | $132.48 | $132.48 – $132.48 |
| 19 | UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $132.48 | $132.48 | $132.48 – $132.48 |
| 20 | WellCare dual medicare/medicaid facility · percent of total billed charges · outpatientfrom % of charges | $132.48 | $132.48 | $132.48 – $132.48 |
| 21 | WellCare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $132.48 | $132.48 | $132.48 – $132.48 |
| 22 | Ambetter commercial professional · fee schedule · both | $133.52 | $133.52 | $133.52 – $133.52 |
| 23 | Caresource commercial facility · percent of total billed charges · outpatientfrom % of charges | $181.13 | $181.13 | $132.48 – $229.77 |
| 24 | UnitedHealthcare commercial professional · fee schedule · both | $203.20 | $203.20 | $203.20 – $203.20 |
| 25 | Aetna commercial professional · fee schedule · both | $223.95 | $223.95 | $223.95 – $223.95 |
Last updated: Feb 11, 2026
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