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
NJX AA&/STRD PLTR COM DG NRV
San Angelo, TX
See all hospitals reporting CPT 64455 →Price type
Shannon River Crest Hospital’s median price of $374 is 4% above the median hospital's median price ($359), higher than 52% of the 1,913 hospitals reporting CPT 64455. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 6 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 managed medicaid facility · fee schedule · outpatient | $19 | $19 | — | — | — | $19 – $19 |
| 2 | Bcbs Tx hmo facility · fee schedule · outpatient | $56 | $56 | — | — | — | $56 – $56 |
| 3 | Bcbs Tx bav facility · fee schedule · outpatient | $59 | $59 | — | — | — | $59 – $59 |
| 4 | Bcbs Tx ppo facility · fee schedule · outpatient | $59 | $59 | — | — | — | $59 – $59 |
| 5 | Humana medicare advantage facility · case rate · outpatient | $277 | $277 | — | — | — | $277 – $277 |
| 6 | Ambetter ppo facility · case rate · outpatient | $596 | $596 | — | — | — | $596 – $596 |
Last updated: Dec 8, 2025
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