CT scan of face and jaw with contrast dye at Holyoke Medical Center

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

CT Maxillofacial W/Dye

Holyoke, MA

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Pricing by billing methodology

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How this price compares nationally

Holyoke Medical Center’s median price of $211 is 51% below the median hospital's median price ($427), higher than 20% of the 2,577 hospitals reporting CPT 70487. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 70487 at Holyoke Medical Center

Negotiated rates from the hospital’s own file: 8 payers, 22 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 ppo - medicare (aetna) professional · fee schedule · both	$46.70	$46.70	$41.91 – $51.48
2	Amerihealth Caritas 8301 professional · fee schedule · both	$47.97	$47.97	$47.97 – $47.97
3	UnitedHealthcare ma mmp one care - h9239-001 professional · fee schedule · both	$54.06	$54.06	$54.06 – $54.06
4	Blue Cross Blue Shield all plans professional · fee schedule · both	$51.90	$55.51	$47.05 – $67.59
5	UnitedHealthcare choyc+ professional · fee schedule · both	$77.57	$77.57	$77.57 – $77.57
6	Aetna aetna commercial facility · other · outpatient	$157.55	$157.55	$157.55 – $157.55
7	Aetna aetna medicare advantage facility · fee schedule · outpatient	$206.85	$206.85	$206.85 – $206.85
8	Blue Cross Blue Shield blue cross blue shield medicare advantage facility · fee schedule · outpatient	$206.85	$206.85	$206.85 – $206.85
9	Medicare medicare facility · fee schedule · outpatient	$206.85	$206.85	$206.85 – $206.85
10	UnitedHealthcare uhc medicare advantage facility · fee schedule · outpatient	$206.85	$206.85	$206.85 – $206.85
11	Medicaid medicaid facility · fee schedule · outpatient	$211.16	$211.16	$211.16 – $211.16
12	UnitedHealthcare uhc evercare (sco) facility · fee schedule · outpatient	$217.19	$217.19	$217.19 – $217.19
13	UnitedHealthcare uhc harvard pilgrim facility · other · outpatient	$306.64	$306.64	$306.64 – $306.64
14	Cigna cigna commercial facility · fee schedule · outpatient	$317.43	$317.43	$317.43 – $317.43
15	Blue Cross Blue Shield blue cross blue shield hmo facility · fee schedule · outpatient	$391.04	$391.04	$391.04 – $391.04
16	Blue Cross Blue Shield blue cross blue shield indemnity facility · fee schedule · outpatient	$391.04	$391.04	$391.04 – $391.04
17	Blue Cross Blue Shield blue cross blue shield ppo facility · fee schedule · outpatient	$391.04	$391.04	$391.04 – $391.04
18	Cigna evernorth bh facility · percent of total billed charges · inpatientfrom % of charges	$704.90	$704.90	$704.90 – $704.90
19	Magellan magellan mass facility · percent of total billed charges · inpatientfrom % of charges	$704.90	$704.90	$704.90 – $704.90
20	Magellan magellan swh facility · percent of total billed charges · inpatientfrom % of charges	$704.90	$704.90	$704.90 – $704.90
21	Cigna cigna commercial facility · percent of total billed charges · inpatientfrom % of charges	$740.14	$740.14	$740.14 – $740.14
22	UnitedHealthcare uhc commercial facility · other · outpatient	$1,666	$1,666	$1,666 – $1,666

Last updated: May 1, 2026

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