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

Botulinum injection of one to four muscles in one arm or leg

CPT 64642the billing code this page is about

Injection of a nerve-blocking drug into one through four muscles of a single limb to reduce muscle tightness or spasm; billed once per limb treated.

Hospitals typically charge $748 cash for this outpatient procedure — the median across 1,374 hospitals that filed a usable cash price; the average of the middle 60% is $788. Most fall between $304 and $1,448 (20th–80th percentile).

Hospitals
1,374
States
50
Filings dated
Dec 2023 – 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 1,374 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
$181$398$748$1,254$2,195

The most expensive tenth of hospitals charges at least 12× what the cheapest tenth charges ($181 vs $2,195).

How the prices are spread

$123 – $171: 50 hospitals$123$171 – $237: 75 hospitals$237 – $331: 103 hospitals$237$331 – $460: 94 hospitals$460 – $641: 194 hospitals$460$641 – $892: 221 hospitals$892 – $1,242: 219 hospitals$892$1,242 – $1,729: 133 hospitals$1,729 – $2,408: 88 hospitals$1,729$2,408 – $3,352: 63 hospitals$2,408median $748price bands are equal on a log scale
Hospitals per price band (1,240 of 1,374 — the bands cover the 5th to 95th percentile)
FromToHospitals
$123$17150
$171$23775
$237$331103
$331$46094
$460$641194
$641$892221
$892$1,242219
$1,242$1,729133
$1,729$2,40888
$2,408$3,35263

Against Medicare

Medicare pays (OPPS 2026, national rate)$721
Median cash price$748
Cash as a multiple of Medicare1.04×

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 $748.

Alaska: 7 hospitals filed a usable price — fewer than 10, so no figureAKMaine: 6 hospitals filed a usable price — fewer than 10, so no figureMEVermont: 5 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 $983 across 39 hospitalsWA$983Idaho: median $455 across 13 hospitalsID$455Montana: 8 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: median $712 across 11 hospitalsND$712Minnesota: median $691 across 54 hospitalsMN$691Illinois: median $748 across 53 hospitalsIL$748Wisconsin: median $637 across 65 hospitalsWI$637Michigan: median $637 across 56 hospitalsMI$637New York: median $852 across 60 hospitalsNY$852Massachusetts: median $1,259 across 35 hospitalsMA$1,259Oregon: median $310 across 19 hospitalsOR$310Nevada: 8 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 5 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 7 hospitals filed a usable price — fewer than 10, so no figureSDIowa: median $356 across 32 hospitalsIA$356Indiana: median $452 across 43 hospitalsIN$452Ohio: median $989 across 71 hospitalsOH$989Pennsylvania: median $814 across 53 hospitalsPA$814New Jersey: median $1,794 across 39 hospitalsNJ$1,794Connecticut: median $571 across 10 hospitalsCT$571Rhode Island: 3 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $1,339 across 82 hospitalsCA$1,339Utah: 3 hospitals filed a usable price — fewer than 10, so no figureUTColorado: median $515 across 21 hospitalsCO$515Nebraska: median $480 across 21 hospitalsNE$480Missouri: median $487 across 43 hospitalsMO$487Kentucky: median $1,185 across 26 hospitalsKY$1,185West Virginia: median $485 across 23 hospitalsWV$485Virginia: median $886 across 39 hospitalsVA$886Maryland: 8 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: 1 hospital filed a usable price — fewer than 10, so no figureDEArizona: median $520 across 15 hospitalsAZ$520New Mexico: 4 hospitals filed a usable price — fewer than 10, so no figureNMKansas: median $606 across 25 hospitalsKS$606Arkansas: 9 hospitals filed a usable price — fewer than 10, so no figureARTennessee: median $291 across 27 hospitalsTN$291North Carolina: median $658 across 36 hospitalsNC$658South Carolina: median $1,074 across 33 hospitalsSC$1,074Oklahoma: median $176 across 21 hospitalsOK$176Louisiana: median $640 across 23 hospitalsLA$640Mississippi: median $397 across 17 hospitalsMS$397Alabama: 9 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: median $1,249 across 44 hospitalsGA$1,249Hawaii: 5 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $989 across 69 hospitalsTX$989Florida: median $1,388 across 59 hospitalsFL$1,388
Cash price by state, most expensive first. National median $748. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
New Jersey NJ39$1,794+140%$767 – $5,339
Florida FL59$1,388+86%$681 – $1,960
California CA82$1,339+79%$826 – $2,038
Massachusetts MA35$1,259+68%$580 – $2,103
Georgia GA44$1,249+67%$1,011 – $3,352
Kentucky KY26$1,185+59%$628 – $3,298
South Carolina SC33$1,074+44%$811 – $1,448
Texas TX69$989+32%$537 – $1,021
Ohio OH71$989+32%$510 – $1,780
Washington WA39$983+31%$235 – $1,259
Virginia VA39$886+19%$255 – $1,174
New York NY60$852+14%$477 – $4,595
Pennsylvania PA53$814+9%$160 – $1,171
Illinois IL53$7480%$242 – $1,106
North Dakota ND11$712−5%$133 – $1,179
Minnesota MN54$691−8%$322 – $766
North Carolina NC36$658−12%$319 – $844
Louisiana LA23$640−14%$376 – $1,176
Michigan MI56$637−15%$79 – $971
Wisconsin WI65$637−15%$397 – $1,088
Kansas KS25$606−19%$187 – $1,200
Connecticut CT10$571−24%$348 – $575
Arizona AZ15$520−30%$233 – $553
Colorado CO21$515−31%$318 – $959
Missouri MO43$487−35%$163 – $889
West Virginia WV23$485−35%$114 – $815
Nebraska NE21$480−36%$285 – $632
Idaho ID13$455−39%$305 – $1,886
Indiana IN43$452−39%$249 – $1,004
Mississippi MS17$397−47%$221 – $614
Iowa IA32$356−52%$260 – $868
Oregon OR19$310−59%$235 – $3,420
Tennessee TN27$291−61%$138 – $596
Oklahoma OK21$176−76%$176 – $423
Alabama AL9not enough hospitals filed a usable price
Arkansas AR9not enough hospitals filed a usable price
New Hampshire NH9not enough hospitals filed a usable price
Maryland MD8not enough hospitals filed a usable price
Montana MT8not enough hospitals filed a usable price
Nevada NV8not enough hospitals filed a usable price
Alaska AK7not enough hospitals filed a usable price
South Dakota SD7not enough hospitals filed a usable price
Maine ME6not enough hospitals filed a usable price
Hawaii HI5not enough hospitals filed a usable price
Vermont VT5not enough hospitals filed a usable price
Wyoming WY5not enough hospitals filed a usable price
New Mexico NM4not enough hospitals filed a usable price
Rhode Island RI3not enough hospitals filed a usable price
Utah UT3not enough hospitals filed a usable price
Delaware DE1not 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 $748.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care1,063$820$393 – $1,561
Children’s61$907$504 – $2,652
Critical access246$484$203 – $930
Ownership
For-profit94$696$298 – $1,245
Government219$631$278 – $1,280
Non-profit1,057$770$322 – $1,524
System affiliation
Part of a system1,142$767$357 – $1,524
Independent232$555$221 – $1,212

Cash price vs list price

Median list price (chargemaster)$1,271
Median cash price$748
Cash as a share of list, median hospital62%

At the typical hospital, asking for the cash price cuts the list price by about 38%. 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

954 hospitals filed a usable inpatient cash price for this code. The median is $826 and the average of the middle 60% is $850; most fall between $397 and $1,559.

Cash price percentiles, inpatient, across 954 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
$233$484$826$1,321$2,048

The most expensive tenth of hospitals charges at least 8.8× what the cheapest tenth charges ($233 vs $2,048).

Of the 1,009 hospitals that filed this code inpatient, 954 gave a usable cash price; 28 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 27 a list price only.

How complete is this

1,374 of the 3,956 hospitals with a price file in our corpus (35%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 1,466 hospitals that filed this code at all gave us
Usable cash price — counted1,374
Cash price carrying a plausibility flag — shown on the compare tool, excluded here59
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded0
A list price only, no cash figure — excluded33
Hospitals that filed this code1,466

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 or closed therapeutic nervous system procedures family.

Hospitals file this code under descriptions such as Hp Chmdn 1 Xtrem 1-4 Muscles.

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, “Botulinum injection of one to four muscles in one arm or leg (CPT 64642) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-64642-botulinum-injection-of-one-to-four-muscles-in-one-arm-or-leg