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Procedure price report · Other non-OR or closed therapeutic nervous system procedures

Neck or upper back facet joint nerve injection, second level

CPT 64491the billing code this page is about

Add-on charge for injecting the nerves of a second cervical or thoracic spinal joint during the same visit; billed with the first-level injection.

Hospitals typically charge $662 cash for this outpatient procedure — the median across 2,074 hospitals that filed a usable cash price; the average of the middle 60% is $712. Most fall between $241 and $1,438 (20th–80th percentile).

Hospitals
2,074
States
50
Filings dated
Aug 2022 – 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 2,074 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
$137$293$662$1,257$1,978

The most expensive tenth of hospitals charges at least 14× what the cheapest tenth charges ($137 vs $1,978).

How the prices are spread

$92 – $131: 92 hospitals$92$131 – $185: 119 hospitals$185 – $263: 137 hospitals$185$263 – $373: 213 hospitals$373 – $529: 216 hospitals$373$529 – $750: 288 hospitals$750 – $1,064: 244 hospitals$750$1,064 – $1,508: 273 hospitals$1,508 – $2,139: 221 hospitals$1,508$2,139 – $3,034: 65 hospitals$2,139median $662price bands are equal on a log scale
Hospitals per price band (1,868 of 2,074 — the bands cover the 5th to 95th percentile)
FromToHospitals
$92$13192
$131$185119
$185$263137
$263$373213
$373$529216
$529$750288
$750$1,064244
$1,064$1,508273
$1,508$2,139221
$2,139$3,03465

By state

The median cash price in each state, against the national median of $662.

Alaska: 8 hospitals filed a usable price — fewer than 10, so no figureAKMaine: median $329 across 17 hospitalsME$329Vermont: 8 hospitals filed a usable price — fewer than 10, so no figureVTNew Hampshire: median $417 across 16 hospitalsNH$417Washington: median $647 across 44 hospitalsWA$647Idaho: median $477 across 21 hospitalsID$477Montana: median $208 across 18 hospitalsMT$208North Dakota: median $336 across 12 hospitalsND$336Minnesota: median $422 across 78 hospitalsMN$422Illinois: median $531 across 92 hospitalsIL$531Wisconsin: median $560 across 79 hospitalsWI$560Michigan: median $320 across 65 hospitalsMI$320New York: median $584 across 61 hospitalsNY$584Massachusetts: median $454 across 38 hospitalsMA$454Oregon: median $324 across 33 hospitalsOR$324Nevada: median $295 across 10 hospitalsNV$295Wyoming: median $430 across 13 hospitalsWY$430South Dakota: median $264 across 12 hospitalsSD$264Iowa: median $379 across 75 hospitalsIA$379Indiana: median $254 across 46 hospitalsIN$254Ohio: median $1,132 across 128 hospitalsOH$1,132Pennsylvania: median $845 across 70 hospitalsPA$845New Jersey: median $1,193 across 35 hospitalsNJ$1,193Connecticut: median $1,104 across 18 hospitalsCT$1,104Rhode Island: 4 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $1,368 across 139 hospitalsCA$1,368Utah: median $962 across 31 hospitalsUT$962Colorado: median $1,083 across 55 hospitalsCO$1,083Nebraska: median $549 across 46 hospitalsNE$549Missouri: median $579 across 55 hospitalsMO$579Kentucky: median $583 across 30 hospitalsKY$583West Virginia: median $575 across 25 hospitalsWV$575Virginia: median $681 across 51 hospitalsVA$681Maryland: 5 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: 6 hospitals filed a usable price — fewer than 10, so no figureDEArizona: median $239 across 22 hospitalsAZ$239New Mexico: median $677 across 13 hospitalsNM$677Kansas: median $533 across 63 hospitalsKS$533Arkansas: median $292 across 14 hospitalsAR$292Tennessee: median $525 across 32 hospitalsTN$525North Carolina: median $1,060 across 46 hospitalsNC$1,060South Carolina: median $1,385 across 30 hospitalsSC$1,385Oklahoma: median $419 across 33 hospitalsOK$419Louisiana: median $291 across 31 hospitalsLA$291Mississippi: median $213 across 32 hospitalsMS$213Alabama: median $625 across 27 hospitalsAL$625Georgia: median $1,179 across 67 hospitalsGA$1,179Hawaii: 9 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $848 across 147 hospitalsTX$848Florida: median $1,302 across 64 hospitalsFL$1,302
Cash price by state, most expensive first. National median $662. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
South Carolina SC30$1,385+109%$486 – $1,385
California CA139$1,368+107%$432 – $1,931
Florida FL64$1,302+97%$672 – $1,978
New Jersey NJ35$1,193+80%$229 – $5,110
Georgia GA67$1,179+78%$1,008 – $1,346
Ohio OH128$1,132+71%$426 – $1,730
Connecticut CT18$1,104+67%$392 – $3,046
Colorado CO55$1,083+64%$412 – $1,734
North Carolina NC46$1,060+60%$454 – $1,611
Utah UT31$962+45%$669 – $1,131
Texas TX147$848+28%$620 – $1,139
Pennsylvania PA70$845+28%$141 – $1,657
Virginia VA51$681+3%$265 – $1,526
New Mexico NM13$677+2%$404 – $870
Washington WA44$647−2%$233 – $1,154
Alabama AL27$625−6%$369 – $3,518
New York NY61$584−12%$166 – $3,393
Kentucky KY30$583−12%$280 – $1,236
Missouri MO55$579−13%$214 – $909
West Virginia WV25$575−13%$168 – $922
Wisconsin WI79$560−15%$296 – $834
Nebraska NE46$549−17%$210 – $1,050
Kansas KS63$533−19%$196 – $860
Illinois IL92$531−20%$222 – $1,418
Tennessee TN32$525−21%$319 – $758
Idaho ID21$477−28%$292 – $1,304
Massachusetts MA38$454−31%$170 – $1,254
Wyoming WY13$430−35%$247 – $973
Minnesota MN78$422−36%$165 – $1,011
Oklahoma OK33$419−37%$159 – $814
New Hampshire NH16$417−37%$131 – $690
Iowa IA75$379−43%$210 – $863
North Dakota ND12$336−49%$108 – $778
Maine ME17$329−50%$138 – $719
Oregon OR33$324−51%$175 – $990
Michigan MI65$320−52%$108 – $690
Nevada NV10$295−55%$177 – $1,611
Arkansas AR14$292−56%$164 – $1,112
Louisiana LA31$291−56%$119 – $714
South Dakota SD12$264−60%$264 – $691
Indiana IN46$254−62%$111 – $734
Arizona AZ22$239−64%$190 – $1,123
Mississippi MS32$213−68%$146 – $620
Montana MT18$208−69%$151 – $613
Hawaii HI9not enough hospitals filed a usable price
Alaska AK8not enough hospitals filed a usable price
Vermont VT8not enough hospitals filed a usable price
Delaware DE6not enough hospitals filed a usable price
Maryland MD5not enough hospitals filed a usable price
Rhode Island RI4not 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 $662.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care1,506$735$279 – $1,527
Children’s37$1,326$341 – $4,341
Critical access523$400$160 – $962
Ownership
For-profit192$989$307 – $1,818
Government380$494$219 – $1,073
Non-profit1,494$668$242 – $1,506
System affiliation
Part of a system1,702$702$264 – $1,526
Independent372$438$171 – $1,001

Cash price vs list price

Median list price (chargemaster)$1,134
Median cash price$662
Cash as a share of list, median hospital63%

At the typical hospital, asking for the cash price cuts the list price by about 37%. 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

1,480 hospitals filed a usable inpatient cash price for this code. The median is $705 and the average of the middle 60% is $761; most fall between $274 and $1,453.

Cash price percentiles, inpatient, across 1,480 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
$152$325$705$1,304$1,929

The most expensive tenth of hospitals charges at least 13× what the cheapest tenth charges ($152 vs $1,929).

Of the 1,590 hospitals that filed this code inpatient, 1,480 gave a usable cash price; 34 carried a plausibility flag, 3 filed a number their own filing marks as not a price, 0 gave an estimate, and 73 a list price only.

How complete is this

2,074 of the 3,956 hospitals with a price file in our corpus (52%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 2,282 hospitals that filed this code at all gave us
Usable cash price — counted2,074
Cash price carrying a plausibility flag — shown on the compare tool, excluded here74
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded3
An estimate rather than a filed cash price — excluded7
A list price only, no cash figure — excluded124
Hospitals that filed this code2,282

Sections not shown for this setting

  • Against Medicare: Medicare has no separately payable national outpatient (OPPS) rate for this code, so there is nothing honest to compare against.
  • 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 or closed therapeutic nervous system procedures family.

Hospitals file this code under descriptions such as Njx Dx/Ther Agt Pvrt Facet Jt Crv/Thrc 2nd Level.

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, “Neck or upper back facet joint nerve injection, second level (CPT 64491) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-64491-neck-or-upper-back-facet-joint-nerve-injection-second-level