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Procedure price report · Other OR therapeutic nervous system procedures

Botulinum injection, 5+ muscles, each extra arm or leg

CPT 64645the billing code this page is about

Add-on charge for injections into five or more muscles of each additional arm or leg treated in the same session.

Hospitals typically charge $366 cash for this outpatient procedure — the median across 1,027 hospitals that filed a usable cash price; the average of the middle 60% is $419. Most fall between $150 and $864 (20th–80th percentile).

Hospitals
1,027
States
49
Filings dated
Jun 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 1,027 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
$108$177$366$726$1,449

The most expensive tenth of hospitals charges at least 13× what the cheapest tenth charges ($108 vs $1,449).

How the prices are spread

$79 – $110: 52 hospitals$79$110 – $152: 104 hospitals$152 – $210: 118 hospitals$152$210 – $291: 112 hospitals$291 – $402: 106 hospitals$291$402 – $556: 104 hospitals$556 – $770: 143 hospitals$556$770 – $1,065: 95 hospitals$1,065 – $1,473: 48 hospitals$1,065$1,473 – $2,038: 43 hospitals$1,473median $366price bands are equal on a log scale
Hospitals per price band (925 of 1,027 — the bands cover the 5th to 95th percentile)
FromToHospitals
$79$11052
$110$152104
$152$210118
$210$291112
$291$402106
$402$556104
$556$770143
$770$1,06595
$1,065$1,47348
$1,473$2,03843

By state

The median cash price in each state, against the national median of $366.

Alaska: 6 hospitals filed a usable price — fewer than 10, so no figureAKMaine: 3 hospitals filed a usable price — fewer than 10, so no figureMEVermont: 4 hospitals filed a usable price — fewer than 10, so no figureVTNew Hampshire: 6 hospitals filed a usable price — fewer than 10, so no figureNHWashington: median $660 across 26 hospitalsWA$660Idaho: median $490 across 10 hospitalsID$490Montana: 7 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: 8 hospitals filed a usable price — fewer than 10, so no figureNDMinnesota: median $525 across 38 hospitalsMN$525Illinois: median $196 across 34 hospitalsIL$196Wisconsin: median $326 across 58 hospitalsWI$326Michigan: median $107 across 51 hospitalsMI$107New York: median $245 across 30 hospitalsNY$245Massachusetts: median $273 across 23 hospitalsMA$273Oregon: median $220 across 12 hospitalsOR$220Nevada: 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: 7 hospitals filed a usable price — fewer than 10, so no figureSDIowa: median $286 across 23 hospitalsIA$286Indiana: median $283 across 37 hospitalsIN$283Ohio: median $900 across 70 hospitalsOH$900Pennsylvania: median $175 across 37 hospitalsPA$175New Jersey: median $4,668 across 27 hospitalsNJ$4,668Connecticut: 8 hospitals filed a usable price — fewer than 10, so no figureCTRhode Island: 1 hospital filed a usable price — fewer than 10, so no figureRICalifornia: median $585 across 71 hospitalsCA$585Utah: 1 hospital filed a usable price — fewer than 10, so no figureUTColorado: median $468 across 18 hospitalsCO$468Nebraska: median $216 across 14 hospitalsNE$216Missouri: median $234 across 37 hospitalsMO$234Kentucky: median $473 across 21 hospitalsKY$473West Virginia: median $254 across 12 hospitalsWV$254Virginia: median $552 across 32 hospitalsVA$552Maryland: 6 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: no hospital in the corpus filed a usable priceDEArizona: median $669 across 12 hospitalsAZ$669New Mexico: 3 hospitals filed a usable price — fewer than 10, so no figureNMKansas: 7 hospitals filed a usable price — fewer than 10, so no figureKSArkansas: 6 hospitals filed a usable price — fewer than 10, so no figureARTennessee: median $184 across 17 hospitalsTN$184North Carolina: median $590 across 23 hospitalsNC$590South Carolina: median $125 across 20 hospitalsSC$125Oklahoma: median $134 across 18 hospitalsOK$134Louisiana: median $186 across 17 hospitalsLA$186Mississippi: median $154 across 17 hospitalsMS$154Alabama: 7 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: median $632 across 25 hospitalsGA$632Hawaii: 4 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $365 across 59 hospitalsTX$365Florida: median $600 across 45 hospitalsFL$600
Cash price by state, most expensive first. National median $366. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
New Jersey NJ27$4,668+1175%$1,850 – $5,410
Ohio OH70$900+146%$281 – $1,449
Arizona AZ12$669+83%$293 – $669
Washington WA26$660+80%$206 – $883
Georgia GA25$632+73%$288 – $638
Florida FL45$600+64%$587 – $1,301
North Carolina NC23$590+61%$185 – $988
California CA71$585+60%$366 – $671
Virginia VA32$552+51%$185 – $666
Minnesota MN38$525+43%$241 – $751
Idaho ID10$490+34%$240 – $770
Kentucky KY21$473+29%$305 – $825
Colorado CO18$468+28%$239 – $825
Texas TX59$3650%$128 – $535
Wisconsin WI58$326−11%$142 – $702
Iowa IA23$286−22%$209 – $479
Indiana IN37$283−23%$177 – $651
Massachusetts MA23$273−25%$147 – $1,491
West Virginia WV12$254−31%$237 – $390
New York NY30$245−33%$108 – $593
Missouri MO37$234−36%$87 – $655
Oregon OR12$220−40%$121 – $386
Nebraska NE14$216−41%$167 – $447
Illinois IL34$196−46%$128 – $776
Louisiana LA17$186−49%$130 – $422
Tennessee TN17$184−50%$126 – $184
Pennsylvania PA37$175−52%$55 – $760
Mississippi MS17$154−58%$118 – $196
Oklahoma OK18$134−63%$134 – $356
South Carolina SC20$125−66%$125 – $253
Michigan MI51$107−71%$93 – $696
Connecticut CT8not enough hospitals filed a usable price
North Dakota ND8not enough hospitals filed a usable price
Alabama AL7not enough hospitals filed a usable price
Kansas KS7not enough hospitals filed a usable price
Montana MT7not enough hospitals filed a usable price
South Dakota SD7not enough hospitals filed a usable price
Alaska AK6not enough hospitals filed a usable price
Arkansas AR6not enough hospitals filed a usable price
Maryland MD6not enough hospitals filed a usable price
New Hampshire NH6not enough hospitals filed a usable price
Nevada NV5not enough hospitals filed a usable price
Hawaii HI4not enough hospitals filed a usable price
Vermont VT4not enough hospitals filed a usable price
Wyoming WY4not enough hospitals filed a usable price
Maine ME3not enough hospitals filed a usable price
New Mexico NM3not enough hospitals filed a usable price
Rhode Island RI1not 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 $366.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care816$366$144 – $855
Children’s56$900$290 – $3,038
Critical access149$272$143 – $702
Ownership
For-profit62$333$154 – $669
Government135$344$162 – $978
Non-profit824$377$142 – $839
System affiliation
Part of a system870$393$154 – $864
Independent157$272$138 – $739

Cash price vs list price

Median list price (chargemaster)$624
Median cash price$366
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

765 hospitals filed a usable inpatient cash price for this code. The median is $411 and the average of the middle 60% is $435; most fall between $155 and $868.

Cash price percentiles, inpatient, across 765 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
$125$185$411$727$1,344

The most expensive tenth of hospitals charges at least 11× what the cheapest tenth charges ($125 vs $1,344).

Of the 807 hospitals that filed this code inpatient, 765 gave a usable cash price; 21 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 21 a list price only.

How complete is this

1,027 of the 3,956 hospitals with a price file in our corpus (26%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 1,124 hospitals that filed this code at all gave us
Usable cash price — counted1,027
Cash price carrying a plausibility flag — shown on the compare tool, excluded here45
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 — excluded52
Hospitals that filed this code1,124

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 OR therapeutic nervous system procedures family.

Hospitals file this code under descriptions such as Chemodenervation 1 Extremity Ea Addl 5/> 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, 5+ muscles, each extra arm or leg (CPT 64645) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-64645-botulinum-injection-5-muscles-each-extra-arm-or-leg