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Procedure price report · Other non-OR lower GI therapeutic procedures

Muscle-relaxing injection into the internal anal muscle

CPT 46505the billing code this page is about

Injection of a nerve-blocking drug, such as botulinum toxin, into the internal muscle ring of the anus to relax it.

Hospitals typically charge $1,645 cash for this outpatient procedure — the median across 827 hospitals that filed a usable cash price; the average of the middle 60% is $2,009. Most fall between $615 and $4,250 (20th–80th percentile).

Hospitals
827
States
49
Filings dated
Jan 2024 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 827 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$395$735$1,645$3,786$6,736

The most expensive tenth of hospitals charges at least 17× what the cheapest tenth charges ($395 vs $6,736).

How the prices are spread

$281 – $392: 41 hospitals$281$392 – $547: 59 hospitals$547 – $764: 71 hospitals$547$764 – $1,066: 57 hospitals$1,066 – $1,489: 127 hospitals$1,066$1,489 – $2,079: 68 hospitals$2,079 – $2,903: 69 hospitals$2,079$2,903 – $4,053: 122 hospitals$4,053 – $5,660: 56 hospitals$4,053$5,660 – $7,903: 75 hospitals$5,660median $1,645price bands are equal on a log scale
Hospitals per price band (745 of 827 — the bands cover the 5th to 95th percentile)
FromToHospitals
$281$39241
$392$54759
$547$76471
$764$1,06657
$1,066$1,489127
$1,489$2,07968
$2,079$2,90369
$2,903$4,053122
$4,053$5,66056
$5,660$7,90375

Against Medicare

Medicare pays (OPPS 2026, national rate)$1,223
Median cash price$1,645
Cash as a multiple of Medicare1.35×

The Medicare figure is the national unadjusted OPPS rate for this code — what Medicare itself pays a hospital before local wage adjustment. It is a benchmark, not a price anyone is charged.

By state

The median cash price in each state, against the national median of $1,645.

Alaska: 3 hospitals filed a usable price — fewer than 10, so no figureAKMaine: 4 hospitals filed a usable price — fewer than 10, so no figureMEVermont: 8 hospitals filed a usable price — fewer than 10, so no figureVTNew Hampshire: 9 hospitals filed a usable price — fewer than 10, so no figureNHWashington: median $1,300 across 28 hospitalsWA$1,300Idaho: median $2,665 across 13 hospitalsID$2,665Montana: 7 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: 2 hospitals filed a usable price — fewer than 10, so no figureNDMinnesota: median $1,439 across 20 hospitalsMN$1,439Illinois: median $1,181 across 42 hospitalsIL$1,181Wisconsin: median $1,457 across 35 hospitalsWI$1,457Michigan: median $1,457 across 42 hospitalsMI$1,457New York: median $1,395 across 48 hospitalsNY$1,395Massachusetts: median $3,581 across 14 hospitalsMA$3,581Oregon: median $572 across 13 hospitalsOR$572Nevada: 5 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 4 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 1 hospital filed a usable price — fewer than 10, so no figureSDIowa: median $733 across 27 hospitalsIA$733Indiana: median $1,792 across 10 hospitalsIN$1,792Ohio: median $3,526 across 35 hospitalsOH$3,526Pennsylvania: median $1,726 across 27 hospitalsPA$1,726New Jersey: median $3,659 across 32 hospitalsNJ$3,659Connecticut: 4 hospitals filed a usable price — fewer than 10, so no figureCTRhode Island: 3 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $3,861 across 59 hospitalsCA$3,861Utah: 1 hospital filed a usable price — fewer than 10, so no figureUTColorado: median $2,594 across 15 hospitalsCO$2,594Nebraska: median $746 across 13 hospitalsNE$746Missouri: median $2,907 across 23 hospitalsMO$2,907Kentucky: median $1,347 across 10 hospitalsKY$1,347West Virginia: median $436 across 13 hospitalsWV$436Virginia: median $5,874 across 14 hospitalsVA$5,874Maryland: 2 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: no hospital in the corpus filed a usable priceDEArizona: 5 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: 7 hospitals filed a usable price — fewer than 10, so no figureNMKansas: median $601 across 23 hospitalsKS$601Arkansas: 6 hospitals filed a usable price — fewer than 10, so no figureARTennessee: 9 hospitals filed a usable price — fewer than 10, so no figureTNNorth Carolina: median $2,360 across 23 hospitalsNC$2,360South Carolina: median $3,557 across 21 hospitalsSC$3,557Oklahoma: median $510 across 16 hospitalsOK$510Louisiana: median $840 across 12 hospitalsLA$840Mississippi: 5 hospitals filed a usable price — fewer than 10, so no figureMSAlabama: median $2,454 across 10 hospitalsAL$2,454Georgia: median $1,202 across 26 hospitalsGA$1,202Hawaii: 2 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $2,463 across 47 hospitalsTX$2,463Florida: median $3,851 across 29 hospitalsFL$3,851
Cash price by state, most expensive first. National median $1,645. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Virginia VA14$5,874+257%$168 – $11,834
California CA59$3,861+135%$1,620 – $3,898
Florida FL29$3,851+134%$1,103 – $7,858
New Jersey NJ32$3,659+122%$1,306 – $5,339
Massachusetts MA14$3,581+118%$1,760 – $5,399
South Carolina SC21$3,557+116%$3,557 – $5,165
Ohio OH35$3,526+114%$827 – $6,706
Missouri MO23$2,907+77%$1,300 – $7,950
Idaho ID13$2,665+62%$642 – $3,234
Colorado CO15$2,594+58%$602 – $3,458
Texas TX47$2,463+50%$1,760 – $6,869
Alabama AL10$2,454+49%$617 – $7,294
North Carolina NC23$2,360+43%$778 – $2,360
Indiana IN10$1,792+9%$299 – $5,852
Pennsylvania PA27$1,726+5%$160 – $6,149
Michigan MI42$1,457−11%$374 – $7,004
Wisconsin WI35$1,457−11%$1,457 – $1,958
Minnesota MN20$1,439−13%$501 – $1,439
New York NY48$1,395−15%$730 – $4,595
Kentucky KY10$1,347−18%$299 – $4,734
Washington WA28$1,300−21%$637 – $3,094
Georgia GA26$1,202−27%$1,194 – $5,778
Illinois IL42$1,181−28%$553 – $3,590
Louisiana LA12$840−49%$458 – $1,249
Nebraska NE13$746−55%$456 – $2,291
Iowa IA27$733−55%$707 – $1,386
Kansas KS23$601−63%$448 – $1,024
Oregon OR13$572−65%$482 – $2,705
Oklahoma OK16$510−69%$510 – $2,404
West Virginia WV13$436−74%$273 – $1,044
New Hampshire NH9not enough hospitals filed a usable price
Tennessee TN9not enough hospitals filed a usable price
Vermont VT8not enough hospitals filed a usable price
Montana MT7not enough hospitals filed a usable price
New Mexico NM7not enough hospitals filed a usable price
Arkansas AR6not enough hospitals filed a usable price
Arizona AZ5not enough hospitals filed a usable price
Mississippi MS5not enough hospitals filed a usable price
Nevada NV5not enough hospitals filed a usable price
Connecticut CT4not enough hospitals filed a usable price
Maine ME4not enough hospitals filed a usable price
Wyoming WY4not enough hospitals filed a usable price
Alaska AK3not enough hospitals filed a usable price
Rhode Island RI3not enough hospitals filed a usable price
Hawaii HI2not enough hospitals filed a usable price
Maryland MD2not enough hospitals filed a usable price
North Dakota ND2not enough hospitals filed a usable price
South Dakota SD1not enough hospitals filed a usable price
Utah UT1not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $1,645.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care650$1,989$733 – $4,595
Children’s32$4,136$1,097 – $5,798
Critical access141$942$445 – $1,958
Ownership
For-profit75$2,463$656 – $5,898
Government134$1,395$587 – $3,528
Non-profit614$1,648$602 – $4,350
System affiliation
Part of a system674$1,958$733 – $4,595
Independent153$873$448 – $2,681

Cash price vs list price

Median list price (chargemaster)$2,926
Median cash price$1,645
Cash as a share of list, median hospital60%

At the typical hospital, asking for the cash price cuts the list price by about 40%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

489 hospitals filed a usable inpatient cash price for this code. The median is $1,457 and the average of the middle 60% is $1,839; most fall between $583 and $3,557.

Cash price percentiles, inpatient, across 489 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$417$733$1,457$3,313$4,734

The most expensive tenth of hospitals charges at least 11× what the cheapest tenth charges ($417 vs $4,734).

Of the 533 hospitals that filed this code inpatient, 489 gave a usable cash price; 24 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 20 a list price only.

How complete is this

827 of the 3,956 hospitals with a price file in our corpus (21%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 897 hospitals that filed this code at all gave us
Usable cash price — counted827
Cash price carrying a plausibility flag — shown on the compare tool, excluded here48
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded7
A list price only, no cash figure — excluded15
Hospitals that filed this code897

Sections not shown for this setting

  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Other non-OR lower GI therapeutic procedures family.

Hospitals file this code under descriptions such as Chemodenervation Internal Anal Sphincter.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Muscle-relaxing injection into the internal anal muscle (CPT 46505) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-46505-muscle-relaxing-injection-into-the-internal-anal-muscle