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
SURG 64491 INJ DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL
Windom, MN
See all hospitals reporting CPT 64491 →Price type
Windom Area Hospital’s median price of $629 is 26% below the median hospital's median price ($848), higher than 40% of the 2,026 hospitals reporting CPT 64491. 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, 29 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 replacement professional · fee schedule · both | $55 | $55 | — | — | — | $55 – $55 |
| 2 | Blue Cross Blue Shield medicare replacement professional · fee schedule · both | $55 | $55 | — | — | — | $55 – $55 |
| 3 | Humana medicare replacement professional · fee schedule · both | $55 | $55 | — | — | — | $55 – $55 |
| 4 | Medica medicare replacement professional · fee schedule · both | $55 | $55 | — | — | — | $55 – $55 |
| 5 | Ucare medicare replacement professional · fee schedule · both | $55 | $55 | — | — | — | $55 – $55 |
| 6 | UnitedHealthcare medicare replacement professional · fee schedule · both | $55 | $55 | — | — | — | $55 – $55 |
| 7 | Medica commercial professional · fee schedule · both | $102 | $102 | — | — | — | $102 – $102 |
| 8 | Bcbs Mn pmap professional · percent of total billed charges · bothfrom % of charges | $384 | $384 | $77 | 20% | — | $307 – $461 |
| 9 | Medica pmap professional · percent of total billed charges · bothfrom % of charges | $384 | $384 | $77 | 20% | — | $307 – $461 |
| 10 | Bcbs Mn pmap facility · percent of total billed charges · inpatientfrom % of charges | $560 | $560 | $112 | 20% | — | $448 – $672 |
| 11 | Bcbs Mn pmap facility · percent of total billed charges · outpatientfrom % of charges | $560 | $560 | $112 | 20% | — | $448 – $672 |
| 12 | Blue Cross Blue Shield managed medicaid facility · percent of total billed charges · inpatientfrom % of charges | $560 | $560 | $112 | 20% | — | $448 – $672 |
| 13 | Blue Cross Blue Shield managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $560 | $560 | $112 | 20% | — | $448 – $672 |
| 14 | Aetna medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $649 | $649 | $130 | 20% | — | $519 – $779 |
| 15 | Blue Cross Blue Shield medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $649 | $649 | $130 | 20% | — | $519 – $779 |
| 16 | Humana medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $649 | $649 | $130 | 20% | — | $519 – $779 |
| 17 | Medica medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $649 | $649 | $130 | 20% | — | $519 – $779 |
| 18 | Ucare medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $649 | $649 | $130 | 20% | — | $519 – $779 |
| 19 | UnitedHealthcare medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $649 | $649 | $130 | 20% | — | $519 – $779 |
| 20 | Medica pmap facility · percent of total billed charges · inpatientfrom % of charges | $733 | $733 | $147 | 20% | — | $586 – $880 |
| 21 | Medica pmap facility · percent of total billed charges · outpatientfrom % of charges | $733 | $733 | $147 | 20% | — | $586 – $880 |
| 22 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $1.2k | $1.2k | $241 | 20% | — | $965 – $1.4k |
| 23 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | $241 | 20% | — | $965 – $1.4k |
| 24 | Bcbs Mn commercial facility · percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | $247 | 20% | — | $990 – $1.5k |
| 25 | Bcbs Nd commercial facility · percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | $247 | 20% | — | $990 – $1.5k |
Last updated: Feb 3, 2026
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