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
HC DESTRUC L/S FACET JNT ADL W/IG
Hanover, PA
See all hospitals reporting CPT 64636 →Price type
UPMC Hanover’s median price of $2.4k is 96% above the median hospital's median price ($1.2k), higher than 79% of the 1,926 hospitals reporting CPT 64636. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 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 | Highmark medicaid facility · fee schedule · outpatient | $61 | $61 | — | — | — | $61 – $61 |
| 2 | UnitedHealthcare pa medicaid facility · fee schedule · outpatient | $63 | $63 | — | — | — | $63 – $63 |
| 3 | Amerihealth Caritas community healthchoices (chc)/medicaid facility · fee schedule · outpatient | $65 | $65 | — | — | — | $65 – $65 |
| 4 | Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $705 | $705 | — | — | — | $705 – $705 |
| 5 | Aetna medicare facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 6 | Blue Cross Blue Shield chip facility · percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 7 | Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 8 | Carefirst commercial facility · percent of total billed charges · inpatientfrom % of charges | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 9 | Carefirst commercial facility · percent of total billed charges · outpatientfrom % of charges | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 10 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · inpatientfrom % of charges | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 11 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · outpatientfrom % of charges | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 12 | Cigna commercial facility · case rate · outpatient | $9.5k | $9.5k | — | — | — | $9.5k – $9.5k |
Last updated: Mar 6, 2026
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