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
Bil Destruct Neu Facet W Imag Guid L/S Sngl
Perryville, MO
See all hospitals reporting CPT 64635 →Price type
Mercy Perry’s median price of $2.0k is 13% below the median hospital's median price ($2.3k), higher than 38% of the 2,140 hospitals reporting CPT 64635. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 16 payers, 29 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 | Medicaid hb wash jefn linc samc pcmh stod il medicaid facility · percent of total billed charges · outpatientfrom % of charges | $355 | $355 | — | — | — | $355 – $355 |
| 2 | UnitedHealthcare hb pcmh uhc medicare w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $718 | $718 | $16 | 2% | 2–20 | $703 – $734 |
| 3 | Blue Cross Blue Shield hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $720 | $720 | — | — | — | $720 – $720 |
| 4 | Humana hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $720 | $720 | — | — | — | $720 – $720 |
| 5 | Medica hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $720 | $720 | — | — | — | $720 – $720 |
| 6 | Medicare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $720 | $720 | — | — | — | $720 – $720 |
| 7 | UnitedHealthcare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $720 | $720 | — | — | — | $720 – $720 |
| 8 | WellCare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $720 | $720 | — | — | — | $720 – $720 |
| 9 | Aetna hb pcmh aetna/coventry medicare 102% w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $749 | $749 | — | — | — | $749 – $749 |
| 10 | Devoted hb pcmh devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $749 | $749 | — | — | — | $749 – $749 |
| 11 | Tricare hb pcmh tricare facility · percent of total billed charges · outpatientfrom % of charges | $859 | $859 | — | — | — | $859 – $859 |
| 12 | Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges | $995 | $995 | — | — | — | $995 – $995 |
| 13 | Ambetter hb pcmh ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 14 | Blue Cross Blue Shield hb stlo wash jefn linc samc cape stod pcmh bcbs ascension facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 15 | UnitedHealthcare hb pcmh uhc core facility · percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 16 | Aetna hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 17 | First Health hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 18 | Optum hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 19 | UnitedHealthcare hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 20 | Blue Cross Blue Shield hb pcmh anthem traditional facility · case rate · outpatient | $1.6k | $1.6k | $503 | 32% | — | $1.1k – $2.1k |
| 21 | Cigna hb pcmh cigna facility · percent of total billed charges · outpatientfrom % of charges | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 22 | MultiPlan hb pcmh multiplan facility · percent of total billed charges · outpatientfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 23 | Blue Cross Blue Shield hb pcmh missouri care health plan/healthy blue facility · fee schedule · outpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 24 | Medicaid hb pcmh mo medicaid facility · fee schedule · outpatient | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 25 | UnitedHealthcare hb pcmh uhc managed medicaid facility · fee schedule · outpatient | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
Last updated: Mar 12, 2026
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