Additional level lumbar or sacral transforaminal epidural injection at Quitman Hospital, LLC

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

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level

Quitman, TX

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How this price compares nationally

Quitman Hospital, LLC’s median price of $549 is 37% below the median hospital's median price ($877), higher than 34% of the 2,050 hospitals reporting CPT 64484. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 64484 at Quitman Hospital, LLC

Negotiated rates from the hospital’s own file: 10 payers, 20 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	Blue Cross Blue Shield blue cross medicare advantage oos [116005] facility · percent of total billed charges · bothfrom % of charges	$324	$334	$84	25%	—	$227 – $461
2	Cigna cigna medicare replacement [126500] facility · percent of total billed charges · bothfrom % of charges	$324	$334	$84	25%	—	$227 – $461
3	Humana humana medicare advantage/ppo/gold [152503] facility · percent of total billed charges · bothfrom % of charges	$324	$334	$84	25%	—	$227 – $461
4	Medicare medicare part a and b [163500] facility · percent of total billed charges · bothfrom % of charges	$324	$334	$84	25%	—	$227 – $461
5	Medicare medicare part a only [163502] facility · percent of total billed charges · bothfrom % of charges	$324	$334	$84	25%	—	$227 – $461
6	Medicare medicare part b only [163501] facility · percent of total billed charges · bothfrom % of charges	$324	$334	$84	25%	—	$227 – $461
7	WellCare wellcare medicare [377501] facility · percent of total billed charges · bothfrom % of charges	$324	$334	$84	25%	—	$227 – $461
8	Aetna aetna coventry medicare replacement [102002] facility · percent of total billed charges · bothfrom % of charges	$330	$340	$86	25%	—	$231 – $470
9	UnitedHealthcare uhc medicare advantage [206511] facility · percent of total billed charges · bothfrom % of charges	$330	$340	$86	25%	—	$231 – $470
10	Ambetter ambetter [293000] facility · percent of total billed charges · bothfrom % of charges	$370	$381	$96	25%	—	$259 – $527
11	Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges	$578	$596	$150	25%	—	$405 – $823
12	Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges	$578	$596	$150	25%	—	$405 – $823
13	Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges	$578	$596	$150	25%	—	$405 – $823
14	Blue Cross Blue Shield bcbs medicaid [116504] facility · percent of total billed charges · bothfrom % of charges	$770	$794	$200	25%	—	$539 – $1.1k
15	Cigna cigna healthspring medicaid replacement [394500] facility · percent of total billed charges · bothfrom % of charges	$770	$794	$200	25%	—	$539 – $1.1k
16	UnitedHealthcare uhc medicaid community plan [375501] facility · percent of total billed charges · bothfrom % of charges	$770	$794	$200	25%	—	$539 – $1.1k
17	Cigna cigna ppo [126025] facility · percent of total billed charges · bothfrom % of charges	$1.3k	$1.4k	$342	25%	—	$921 – $1.9k
18	Cigna cigna - great west [126009] facility · percent of total billed charges · bothfrom % of charges	$1.4k	$1.5k	$373	25%	—	$1.0k – $2.0k
19	Humana humana commercial [214001] facility · percent of total billed charges · bothfrom % of charges	$1.4k	$1.5k	$373	25%	—	$1.0k – $2.0k
20	Phcs phcs multiplan [178000] facility · percent of total billed charges · bothfrom % of charges	$1.4k	$1.5k	$373	25%	—	$1.0k – $2.0k

Last updated: Feb 12, 2026

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