CT scan of neck with contrast dye at IHC Health Services Inc., DBA Intermountain Primary Children's Hospital

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

HC CT NECK SOFT TISSUE W/CONTRAST

Lehi, UT

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Pricing by billing methodology

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How this price compares nationally

IHC Health Services Inc., DBA Intermountain Primary Children's Hospital’s median price of $857 is 88% above the median hospital's median price ($456), higher than 68% of the 2,626 hospitals reporting CPT 70491. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 70491 at IHC Health Services Inc., DBA Intermountain Primary Children's Hospital

Negotiated rates from the hospital’s own file: 8 payers, 55 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	Molina medicaid professional · fee schedule · outpatient	$91.70	$91.70	$64.82 – $118.57
2	Molina medicare advantage professional · fee schedule · outpatient	$91.70	$91.70	$64.82 – $118.57
3	Molina medicare choice care hmo professional · fee schedule · outpatient	$91.70	$91.70	$64.82 – $118.57
4	Molina medicare complete care hmo snp professional · fee schedule · outpatient	$91.70	$91.70	$64.82 – $118.57
5	UnitedHealthcare medicare advantage professional · fee schedule · outpatient	$91.70	$91.70	$64.82 – $118.57
6	Molina medicaid facility · case rate · outpatient	$102.74	$102.74	$102.74 – $102.74
7	Molina medicare advantage facility · case rate · outpatient	$110.96	$110.96	$110.96 – $110.96
8	Molina medicare choice care hmo facility · case rate · outpatient	$110.96	$110.96	$110.96 – $110.96
9	Molina medicare complete care hmo snp facility · case rate · outpatient	$110.96	$110.96	$110.96 – $110.96
10	Tricare tricare facility · case rate · outpatient	$170.66	$170.66	$170.66 – $170.66
11	UnitedHealthcare medicare advantage facility · case rate · outpatient	$170.66	$170.66	$170.66 – $170.66
12	UnitedHealthcare medicare advantage facility · percent of total billed charges · inpatientfrom % of charges	$495.10	$495.10	$495.10 – $495.10
13	Molina medicare advantage facility · percent of total billed charges · inpatientfrom % of charges	$724.54	$724.54	$724.54 – $724.54
14	Molina medicare choice care hmo facility · percent of total billed charges · inpatientfrom % of charges	$724.54	$724.54	$724.54 – $724.54
15	Molina medicare complete care hmo snp facility · percent of total billed charges · inpatientfrom % of charges	$724.54	$724.54	$724.54 – $724.54
16	Aetna connected facility · percent of total billed charges · inpatientfrom % of charges	$857.37	$857.37	$857.37 – $857.37
17	Aetna extended facility · percent of total billed charges · inpatientfrom % of charges	$857.37	$857.37	$857.37 – $857.37
18	Aetna standard facility · percent of total billed charges · inpatientfrom % of charges	$857.37	$857.37	$857.37 – $857.37
19	Cigna hmo facility · percent of total billed charges · inpatientfrom % of charges	$857.37	$857.37	$857.37 – $857.37
20	Cigna open access flex facility · percent of total billed charges · inpatientfrom % of charges	$857.37	$857.37	$857.37 – $857.37
21	Cigna ppo/epo facility · percent of total billed charges · inpatientfrom % of charges	$857.37	$857.37	$857.37 – $857.37
22	Cigna utah connect/local plus facility · percent of total billed charges · inpatientfrom % of charges	$857.37	$857.37	$857.37 – $857.37
23	Humana commercial facility · percent of total billed charges · inpatientfrom % of charges	$857.37	$857.37	$857.37 – $857.37
24	Molina chip facility · percent of total billed charges · inpatientfrom % of charges	$857.37	$857.37	$857.37 – $857.37
25	Molina marketplace facility · percent of total billed charges · inpatientfrom % of charges	$857.37	$857.37	$857.37 – $857.37

Page 1 of 3 · 55 rates

Last updated: Aug 5, 2026

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