Botox injections to relax facial muscles on one side at Mary Bridge Children's Hospital

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

C CHEMODENERVATION OF MUSCLE INNERVATED BY FACIAL NERVE, UNILATERAL

Tacoma, WA

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How this price compares nationally

Mary Bridge Children's Hospital’s median price of $1.3k is 219% above the median hospital's median price ($393), higher than 83% of the 1,913 hospitals reporting CPT 64612. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 64612 at Mary Bridge Children's Hospital

Negotiated rates from the hospital’s own file: 11 payers, 25 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	Molina apple health fee schedule · outpatient	$307.61	$307.61	$307.61 – $307.61
2	UnitedHealthcare apple health fee schedule · outpatient	$332.22	$332.22	$332.22 – $332.22
3	Aetna medadvantage fee schedule · outpatient	$361.60	$361.60	$361.60 – $361.60
4	Regence medadvantage fee schedule · outpatient	$361.60	$361.60	$361.60 – $361.60
5	UnitedHealthcare medadvantage hmo fee schedule · outpatient	$365.11	$365.11	$365.11 – $365.11
6	Molina medadvantage fee schedule · outpatient	$368.62	$368.62	$368.62 – $368.62
7	WellCare medadvantage fee schedule · outpatient	$368.62	$368.62	$368.62 – $368.62
8	Premera hmo fee schedule · outpatient	$509.35	$509.35	$509.35 – $509.35
9	Premera signature fee schedule · outpatient	$1,082	$1,082	$1,082 – $1,082
10	Ambetter coordinated care exchange fee schedule · outpatient	$1,092	$1,092	$1,092 – $1,092
11	Premera prime fee schedule · outpatient	$1,107	$1,107	$1,107 – $1,107
12	Premera other commercial plans fee schedule · outpatient	$1,360	$1,360	$1,360 – $1,360
13	First Health all commercial plans percent of total billed charges · inpatientfrom % of charges	$1,407	$1,407	$1,407 – $1,407
14	First Health all commercial plans percent of total billed charges · outpatientfrom % of charges	$1,407	$1,407	$1,407 – $1,407
15	Cigna all commercial plans percent of total billed charges · inpatientfrom % of charges	$1,418	$1,418	$1,418 – $1,418
16	MultiPlan all commercial plans percent of total billed charges · inpatientfrom % of charges	$1,425	$1,425	$1,425 – $1,425
17	MultiPlan all commercial plans percent of total billed charges · outpatientfrom % of charges	$1,425	$1,425	$1,425 – $1,425
18	Cigna all commercial plans percent of total billed charges · outpatientfrom % of charges	$1,450	$1,450	$1,450 – $1,450
19	Regence blue high performance fee schedule · outpatient	$1,505	$1,505	$1,505 – $1,505
20	Regence mcc/ahn fee schedule · outpatient	$1,505	$1,505	$1,505 – $1,505
21	Regence realvalue fee schedule · outpatient	$1,548	$1,548	$1,548 – $1,548
22	Regence commercial fee schedule · outpatient	$1,720	$1,720	$1,720 – $1,720
23	Aetna all commercial plans fee schedule · outpatient	$2,019	$2,019	$2,019 – $2,019
24	Kaiser hmo/ppo fee schedule · outpatient	$2,138	$2,138	$2,138 – $2,138
25	UnitedHealthcare all commercial plans fee schedule · outpatient	$2,888	$2,888	$2,888 – $2,888

Last updated: Aug 27, 2026

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