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
HC CT MAXILLOFACIAL W/CONTRAST
Panguitch, UT
See all hospitals reporting CPT 70487 →Price type
Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital’s median price of $2.3k is 430% above the median hospital's median price ($427), higher than 92% of the 2,577 hospitals reporting CPT 70487. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 47 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 aetna medicare hmo professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 2 | Aetna aetna medicare ppo professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 3 | Molina medicaid professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 4 | Molina molina healthcare medicaid hmo professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 5 | Molina molina medicare complete care hmo snp professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 6 | Aetna aetna standard network aka aetna health plan network for utah facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 7 | Aetna aetna utah connected network facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 8 | Aetna aetna whole health connected utah network facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 9 | Cigna cigna managed care (hmo or open access plus aka oap) facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 10 | Cigna ppo/epo facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 11 | Aetna aetna medicare hmo facility · percent of total billed charges · outpatientfrom % of charges | $966.05 | $966.05 | $966.05 – $966.05 |
| 12 | Aetna aetna medicare ppo facility · percent of total billed charges · outpatientfrom % of charges | $966.05 | $966.05 | $966.05 – $966.05 |
| 13 | Molina medicaid facility · percent of total billed charges · outpatientfrom % of charges | $966.05 | $966.05 | $966.05 – $966.05 |
| 14 | Molina molina healthcare medicaid hmo facility · percent of total billed charges · outpatientfrom % of charges | $966.05 | $966.05 | $966.05 – $966.05 |
| 15 | Molina molina medicare complete care hmo snp facility · percent of total billed charges · outpatientfrom % of charges | $1,068 | $1,068 | $1,068 – $1,068 |
| 16 | Tricare tricare (hnfs) military program facility · percent of total billed charges · outpatientfrom % of charges | $1,101 | $1,101 | $1,101 – $1,101 |
| 17 | Tricare tricare (hnfs) military program facility · percent of total billed charges · inpatientfrom % of charges | $1,310 | $1,310 | $1,310 – $1,310 |
| 18 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $2,085 | $2,085 | $2,085 – $2,085 |
| 19 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $2,135 | $2,135 | $2,135 – $2,135 |
| 20 | Molina medicaid facility · percent of total billed charges · inpatientfrom % of charges | $2,263 | $2,263 | $2,263 – $2,263 |
| 21 | Molina molina healthcare medicaid hmo facility · percent of total billed charges · inpatientfrom % of charges | $2,263 | $2,263 | $2,263 – $2,263 |
| 22 | Aetna aetna extended network facility · percent of total billed charges · inpatientfrom % of charges | $2,415 | $2,415 | $2,415 – $2,415 |
| 23 | Aetna aetna standard network aka aetna health plan network for utah facility · percent of total billed charges · inpatientfrom % of charges | $2,415 | $2,415 | $2,415 – $2,415 |
| 24 | Aetna aetna standard network aka aetna health plan network for utah facility · percent of total billed charges · outpatientfrom % of charges | $2,415 | $2,415 | $2,415 – $2,415 |
| 25 | Aetna aetna utah connected network facility · percent of total billed charges · inpatientfrom % of charges | $2,415 | $2,415 | $2,415 – $2,415 |
Last updated: Aug 5, 2026
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