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
Richfield, UT
See all hospitals reporting CPT 70487 →Price type
IHC Health Services Inc., DBA Intermountain Health Sevier Valley Hospital’s median price of $2.2k is 406% above the median hospital's median price ($427), higher than 91% 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: 6 payers, 57 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 medicare adv hmo professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 2 | Aetna medicare adv ppo professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 3 | Humana medicare choice ppo professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 4 | Molina medicaid professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 5 | Molina medicare choice care hmo professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 6 | Molina medicare complete care hmo snp professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 7 | UnitedHealthcare medicare advantage professional · fee schedule · outpatient | $75.40 | $75.40 | $52.92 – $97.88 |
| 8 | Molina medicaid facility · case rate · outpatient | $157.40 | $157.40 | $157.40 – $157.40 |
| 9 | UnitedHealthcare medicare advantage facility · case rate · outpatient | $190.21 | $190.21 | $190.21 – $190.21 |
| 10 | Humana medicare choice ppo facility · case rate · outpatient | $199.72 | $199.72 | $199.72 – $199.72 |
| 11 | Aetna medicare adv hmo facility · case rate · outpatient | $205.42 | $205.42 | $205.42 – $205.42 |
| 12 | Molina medicare choice care hmo facility · case rate · outpatient | $205.42 | $205.42 | $205.42 – $205.42 |
| 13 | Molina medicare complete care hmo snp facility · case rate · outpatient | $205.42 | $205.42 | $205.42 – $205.42 |
| 14 | Aetna medicare adv ppo facility · case rate · outpatient | $209.23 | $209.23 | $209.23 – $209.23 |
| 15 | Aetna connected facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 16 | Aetna standard facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 17 | Cigna hmo facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 18 | Cigna ppo/epo facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 19 | Regence blueoption facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 20 | UnitedHealthcare charter ut facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 21 | UnitedHealthcare non-options ppo facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 22 | UnitedHealthcare options ppo facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 23 | Molina medicaid facility · percent of total billed charges · inpatientfrom % of charges | $2,263 | $2,263 | $2,263 – $2,263 |
| 24 | Aetna connected facility · percent of total billed charges · inpatientfrom % of charges | $2,415 | $2,415 | $2,415 – $2,415 |
| 25 | Aetna extended 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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