Additional level lumbar or sacral transforaminal epidural injection at Lafayette County

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

HC INJ(S) FORAMEN EPID L/S ADDTL LEV

Darlington, WI

See all payers reporting CPT 64484 →

Payers reporting CPT 64484 at Lafayette County

Negotiated rates from the hospital’s own file: 4 payers, 19 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 · fee schedule · both	$54	$54	—	—	—	$54 – $54
2	Anthem commercial professional · fee schedule · both	$54	$54	—	—	—	$54 – $54
3	Anthem medicare advantage professional · fee schedule · both	$54	$54	—	—	—	$54 – $54
4	Humana commercial professional · fee schedule · both	$54	$54	—	—	—	$54 – $54
5	Humana medicare advantage professional · fee schedule · both	$54	$54	—	—	—	$54 – $54
6	UnitedHealthcare medicare advantage professional · fee schedule · both	$54	$54	—	—	—	$54 – $54
7	UnitedHealthcare commercial professional · fee schedule · both	$71	$71	—	—	—	$71 – $71
8	Anthem badgercare professional · fee schedule · both	$118	$118	—	—	—	$118 – $118
9	UnitedHealthcare badgercare professional · fee schedule · both	$118	$118	—	—	—	$118 – $118
10	Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k
11	Anthem medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k
12	Humana medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k
13	UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k
14	Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges	$2.4k	$2.4k	—	—	—	$2.4k – $2.4k
15	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$2.4k	$2.4k	—	—	—	$2.4k – $2.4k
16	UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges	$2.4k	$2.4k	—	—	—	$2.4k – $2.4k
17	Anthem commercial facility · percent of total billed charges · outpatientfrom % of charges	$3.0k	$3.0k	—	—	—	$3.0k – $3.0k
18	Humana commercial facility · percent of total billed charges · inpatientfrom % of charges	$3.5k	$3.5k	—	—	—	$3.5k – $3.5k
19	Humana commercial facility · percent of total billed charges · outpatientfrom % of charges	$3.5k	$3.5k	—	—	—	$3.5k – $3.5k