CT scan of face and jaw with contrast dye at Intermountain Front Range Inc. Dba Intermountain Health Lutheran 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 MAXILLOFACIAL W/CONTRAST

WHEAT RIDGE, CO

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How this price compares nationally

Intermountain Front Range Inc. Dba Intermountain Health Lutheran Hospital’s median price of $1.4k is 233% above the median hospital's median price ($427), higher than 83% 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 Intermountain Front Range Inc. Dba Intermountain Health Lutheran Hospital

Negotiated rates from the hospital’s own file: 8 payers, 95 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	UnitedHealthcare uhc mrp php prime facility · case rate · outpatient	$177.11	$177.11	$177.11 – $177.11
2	UnitedHealthcare uhc rmhp mrp dualcare facility · case rate · outpatient	$177.11	$177.11	$177.11 – $177.11
3	UnitedHealthcare united healthcare mrp facility · case rate · outpatient	$177.11	$177.11	$177.11 – $177.11
4	UnitedHealthcare united healthcare optum mrp facility · case rate · outpatient	$177.11	$177.11	$177.11 – $177.11
5	Kaiser kaiser snp facility · case rate · outpatient	$178.90	$178.90	$178.90 – $178.90
6	Aetna aetna colorado preferred facility · fee schedule · outpatient	$349.39	$349.39	$349.39 – $349.39
7	Aetna aetna hmo/epo facility · fee schedule · outpatient	$380.51	$380.51	$380.51 – $380.51
8	Aetna aetna indemnity facility · fee schedule · outpatient	$380.51	$380.51	$380.51 – $380.51
9	Aetna aetna other facility · fee schedule · outpatient	$380.51	$380.51	$380.51 – $380.51
10	Aetna aetna pos/qpos facility · fee schedule · outpatient	$380.51	$380.51	$380.51 – $380.51
11	Aetna aetna ppo facility · fee schedule · outpatient	$380.51	$380.51	$380.51 – $380.51
12	Aetna aetna src facility · fee schedule · outpatient	$380.51	$380.51	$380.51 – $380.51
13	Aetna christian brothers emp ben trst facility · fee schedule · outpatient	$380.51	$380.51	$380.51 – $380.51
14	Kaiser kp select hmo facility · percent of total billed charges · outpatientfrom % of charges	$624.03	$624.03	$624.03 – $624.03
15	Kaiser kaiser hmo exchange plan facility · percent of total billed charges · outpatientfrom % of charges	$775.82	$775.82	$775.82 – $775.82
16	Kaiser kaiser out of state facility · percent of total billed charges · outpatientfrom % of charges	$775.82	$775.82	$775.82 – $775.82
17	Kaiser kaiser permanente hmo facility · percent of total billed charges · outpatientfrom % of charges	$775.82	$775.82	$775.82 – $775.82
18	Kaiser kaiser self funded facility · percent of total billed charges · outpatientfrom % of charges	$775.82	$775.82	$775.82 – $775.82
19	Kaiser kaiser perm ppo/pos facility · percent of total billed charges · outpatientfrom % of charges	$787.29	$787.29	$787.29 – $787.29
20	Cigna cigna sclhs cdhp facility · percent of total billed charges · outpatientfrom % of charges	$843.29	$843.29	$843.29 – $843.29
21	Cigna cigna co public option facility · percent of total billed charges · outpatientfrom % of charges	$858.47	$858.47	$858.47 – $858.47
22	Cigna cigna connect exchange facility · percent of total billed charges · outpatientfrom % of charges	$858.47	$858.47	$858.47 – $858.47
23	Cigna cigna surefit facility · percent of total billed charges · outpatientfrom % of charges	$858.47	$858.47	$858.47 – $858.47
24	Anthem bcbs co exchange plan facility · fee schedule · outpatient	$886.00	$886.00	$886.00 – $886.00
25	Anthem bcbs co federal facility · fee schedule · outpatient	$886.00	$886.00	$886.00 – $886.00

Page 1 of 4 · 95 rates

Last updated: Mar 22, 2026

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