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
Destroy nerve face muscle
Lebanon, NH
See all hospitals reporting CPT 64612 →Price type
Mary Hitchcock Memorial Hospital’s median price of $373 is 5% below the median hospital's median price ($393), higher than 46% 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: 10 payers, 103 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 | Amerihealth Caritas amerihealth caritas - nh managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $74.55 | $74.55 | $74.55 – $74.55 |
| 2 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · fee schedule · outpatient | $82.00 | $82.00 | $82.00 – $82.00 |
| 3 | Anthem anthem - medicare advantage - dhp professional · fee schedule · outpatient | $85.94 | $89.62 | $77.82 – $108.78 |
| 4 | Bcbs Vt bcbs of vermont - medicare advantage - dhp professional · fee schedule · outpatient | $85.94 | $89.62 | $77.82 – $108.78 |
| 5 | UnitedHealthcare uhc - medicare advantage - dhp professional · fee schedule · outpatient | $85.94 | $89.62 | $77.82 – $108.78 |
| 6 | UnitedHealthcare uhc - va community care network - dhpn professional · fee schedule · outpatient | $85.94 | $89.62 | $77.82 – $108.78 |
| 7 | Aetna aetna medicare advantage - dhp professional · fee schedule · outpatient | $88.52 | $92.31 | $80.15 – $112.04 |
| 8 | WellCare wellcare - medicare advantage - dhp professional · fee schedule · outpatient | $89.38 | $93.20 | $80.93 – $113.13 |
| 9 | Ambetter ambetter commercial - exchange behavioral health - dhp professional · fee schedule · outpatient | $90.24 | $94.10 | $81.71 – $114.22 |
| 10 | Cigna cigna medicare advantage - dhp professional · fee schedule · outpatient | $104.46 | $104.46 | $96.88 – $112.04 |
| 11 | UnitedHealthcare uhc - va community care network - dhps professional · fee schedule · outpatient | $126.78 | $126.78 | $117.58 – $135.98 |
| 12 | Bcbs Vt bcbs of vermont - the vermont health plan professional · fee schedule · outpatient | $89.26 | $159.79 | $81.63 – $371.44 |
| 13 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · percent of total billed charges · outpatientfrom % of charges | $167.80 | $167.80 | $167.80 – $167.80 |
| 14 | Ambetter ambetter commercial - exchange - dhpn professional · fee schedule · outpatient | $193.10 | $205.41 | $77.82 – $357.62 |
| 15 | Ambetter ambetter commercial - exchange - dhps professional · fee schedule · outpatient | $240.57 | $240.57 | $223.11 – $258.03 |
| 16 | Amerihealth Caritas amerihealth caritas - nh managed medicaid - dhp professional · fee schedule · outpatient | $254.64 | $254.64 | $254.64 – $254.64 |
| 17 | Bcbs Vt bcbs of vermont - the vermont health plan facility · case rate · outpatient | $304.56 | $304.56 | $304.56 – $304.56 |
| 18 | Bcbs Vt bcbs of vermont - vermont health partnership facility · case rate · outpatient | $304.56 | $304.56 | $304.56 – $304.56 |
| 19 | Cigna cigna hmo-pos professional · fee schedule · outpatient | $314.83 | $314.83 | $293.77 – $335.88 |
| 20 | Cigna cigna ppo - dhp professional · fee schedule · outpatient | $315.13 | $315.13 | $291.52 – $338.73 |
| 21 | UnitedHealthcare uhc - freedom plan facility · percent of total billed charges · outpatientfrom % of charges | $323.08 | $323.08 | $323.08 – $323.08 |
| 22 | Anthem anthem - medicare advantage facility · fee schedule · outpatient | $330.34 | $330.34 | $330.34 – $330.34 |
| 23 | Bcbs Vt bcbs of vermont - medicare advantage facility · fee schedule · outpatient | $330.34 | $330.34 | $330.34 – $330.34 |
| 24 | UnitedHealthcare uhc - medicare advantage facility · fee schedule · outpatient | $330.34 | $330.34 | $330.34 – $330.34 |
| 25 | UnitedHealthcare uhc - va community care network facility · fee schedule · outpatient | $330.34 | $330.34 | $330.34 – $330.34 |
Last updated: Jan 1, 2026
See Botox injections to relax facial muscles on one side pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.