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
INJ PARAVERT F JNT C/T 1 LEV
Jasper, TX
See all hospitals reporting CPT 64490 →Price type
Southeast Texas - Jasper Memorial’s median price of $898 is 27% below the median hospital's median price ($1.2k), higher than 27% of the 2,244 hospitals reporting CPT 64490. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 30 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 | UnitedHealthcare chip km case rate · outpatient | $285 | $285 | — | — | — | $285 – $285 |
| 2 | UnitedHealthcare star kid km case rate · outpatient | $285 | $285 | — | — | — | $285 – $285 |
| 3 | UnitedHealthcare star km case rate · outpatient | $285 | $285 | — | — | — | $285 – $285 |
| 4 | UnitedHealthcare star plus km case rate · outpatient | $285 | $285 | — | — | — | $285 – $285 |
| 5 | Molina chip km fee schedule · outpatient | $358 | $358 | — | — | — | $358 – $358 |
| 6 | Molina star km fee schedule · outpatient | $358 | $358 | — | — | — | $358 – $358 |
| 7 | Molina star plus km fee schedule · outpatient | $358 | $358 | — | — | — | $358 – $358 |
| 8 | Aetna mm fee schedule · outpatient | $898 | $898 | — | — | — | $898 – $898 |
| 9 | Bcbs Tx mm fee schedule · outpatient | $898 | $898 | — | — | — | $898 – $898 |
| 10 | Humana gold choice mm fee schedule · outpatient | $898 | $898 | — | — | — | $898 – $898 |
| 11 | Molina medicare adv mm fee schedule · outpatient | $898 | $898 | — | — | — | $898 – $898 |
| 12 | UnitedHealthcare mm fee schedule · outpatient | $898 | $898 | — | — | — | $898 – $898 |
| 13 | WellCare mm fee schedule · outpatient | $898 | $898 | — | — | — | $898 – $898 |
| 14 | Devoted mm fee schedule · outpatient | $970 | $970 | — | — | — | $970 – $970 |
| 15 | UnitedHealthcare hix case rate · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 16 | Humana choicecare other · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 17 | Bcbs Tx heb fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 18 | Aetna new business case rate · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 19 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 20 | Aetna epo case rate · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 21 | Aetna hmo case rate · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 22 | Aetna pos case rate · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 23 | Aetna ppo case rate · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 24 | Bcbs Tx hmo fee schedule · outpatient | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 25 | UnitedHealthcare all payer case rate · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
Last updated: Jan 13, 2026
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