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 CTA HEAD W/WO CONTRAST
Panguitch, UT
See all hospitals reporting CPT 70496 →Price type
Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital’s median price of $2.4k is 365% above the median hospital's median price ($519), higher than 89% of the 2,615 hospitals reporting CPT 70496. 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 | $124.44 | $124.44 | $82.00 – $166.88 |
| 2 | Aetna aetna medicare ppo professional · fee schedule · outpatient | $124.44 | $124.44 | $82.00 – $166.88 |
| 3 | Molina medicaid professional · fee schedule · outpatient | $124.44 | $124.44 | $82.00 – $166.88 |
| 4 | Molina molina healthcare medicaid hmo professional · fee schedule · outpatient | $124.44 | $124.44 | $82.00 – $166.88 |
| 5 | Molina molina medicare complete care hmo snp professional · fee schedule · outpatient | $124.44 | $124.44 | $82.00 – $166.88 |
| 6 | Aetna aetna standard network aka aetna health plan network for utah facility · fee schedule · outpatient | $960.00 | $960.00 | $960.00 – $960.00 |
| 7 | Aetna aetna utah connected network facility · fee schedule · outpatient | $960.00 | $960.00 | $960.00 – $960.00 |
| 8 | Aetna aetna whole health connected utah network facility · fee schedule · outpatient | $960.00 | $960.00 | $960.00 – $960.00 |
| 9 | Cigna cigna managed care (hmo or open access plus aka oap) facility · fee schedule · outpatient | $960.00 | $960.00 | $960.00 – $960.00 |
| 10 | Cigna ppo/epo facility · fee schedule · outpatient | $960.00 | $960.00 | $960.00 – $960.00 |
| 11 | Aetna aetna medicare hmo facility · percent of total billed charges · outpatientfrom % of charges | $1,031 | $1,031 | $1,031 – $1,031 |
| 12 | Aetna aetna medicare ppo facility · percent of total billed charges · outpatientfrom % of charges | $1,031 | $1,031 | $1,031 – $1,031 |
| 13 | Molina medicaid facility · percent of total billed charges · outpatientfrom % of charges | $1,031 | $1,031 | $1,031 – $1,031 |
| 14 | Molina molina healthcare medicaid hmo facility · percent of total billed charges · outpatientfrom % of charges | $1,031 | $1,031 | $1,031 – $1,031 |
| 15 | Molina molina medicare complete care hmo snp facility · percent of total billed charges · outpatientfrom % of charges | $1,139 | $1,139 | $1,139 – $1,139 |
| 16 | Tricare tricare (hnfs) military program facility · percent of total billed charges · outpatientfrom % of charges | $1,175 | $1,175 | $1,175 – $1,175 |
| 17 | Tricare tricare (hnfs) military program facility · percent of total billed charges · inpatientfrom % of charges | $1,397 | $1,397 | $1,397 – $1,397 |
| 18 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $2,224 | $2,224 | $2,224 – $2,224 |
| 19 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $2,278 | $2,278 | $2,278 – $2,278 |
| 20 | Molina medicaid facility · percent of total billed charges · inpatientfrom % of charges | $2,414 | $2,414 | $2,414 – $2,414 |
| 21 | Molina molina healthcare medicaid hmo facility · percent of total billed charges · inpatientfrom % of charges | $2,414 | $2,414 | $2,414 – $2,414 |
| 22 | Aetna aetna extended network facility · percent of total billed charges · inpatientfrom % of charges | $2,577 | $2,577 | $2,577 – $2,577 |
| 23 | Aetna aetna standard network aka aetna health plan network for utah facility · percent of total billed charges · inpatientfrom % of charges | $2,577 | $2,577 | $2,577 – $2,577 |
| 24 | Aetna aetna standard network aka aetna health plan network for utah facility · percent of total billed charges · outpatientfrom % of charges | $2,577 | $2,577 | $2,577 – $2,577 |
| 25 | Aetna aetna utah connected network facility · percent of total billed charges · inpatientfrom % of charges | $2,577 | $2,577 | $2,577 – $2,577 |
Last updated: Aug 5, 2026
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