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
DEST CRV/THR FCT JNT ADD W IMG
Jamestown, NY
See all hospitals reporting CPT 64634 →Price type
UPMC Chautauqua’s median price of $3.5k is 231% above the median hospital's median price ($1.1k), higher than 91% of the 1,858 hospitals reporting CPT 64634. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 12 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 | Aetna medicare facility · fee schedule · outpatient | $60 | $60 | — | — | — | $60 – $60 |
| 2 | Blue Cross Blue Shield medicaid facility · case rate · outpatient | $749 | $749 | — | — | — | $749 – $749 |
| 3 | Blue Cross Blue Shield commercial facility · case rate · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 4 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 5 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 6 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 7 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 8 | Humana commercial facility · percent of total billed charges · inpatientfrom % of charges | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 9 | MultiPlan ppo (includes phcs as a payer) facility · percent of total billed charges · inpatientfrom % of charges | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 10 | MultiPlan ppo (includes phcs as a payer) facility · percent of total billed charges · outpatientfrom % of charges | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 11 | Humana commercial facility · percent of total billed charges · outpatientfrom % of charges | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 12 | First Health ppo facility · percent of total billed charges · outpatientfrom % of charges | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
Last updated: Mar 6, 2026
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