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
CHG CT MAXILLOFACIAL W/O CONTRAST MATERIAL
Jasper, IN
See all hospitals reporting CPT 70486 →Price type
Little Company of Mary Hospital of Indiana Inc’s median price of $129 is 60% below the median hospital's median price ($321), higher than 17% of the 2,630 hospitals reporting CPT 70486. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 21 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 | Anthem hmo/ppo/traditional facility · fee schedule · outpatient | $80.75 | $80.75 | $80.75 – $80.75 |
| 2 | Tricare government facility · case rate · outpatient | $94.69 | $94.69 | $94.69 – $94.69 |
| 3 | Aetna medicare advantage professional · fee schedule · both | $117.75 | $97.73 | $37.67 – $117.75 |
| 4 | Anthem medicare advantage professional · fee schedule · both | $117.75 | $97.73 | $37.67 – $117.75 |
| 5 | Caresource medicare advantage professional · fee schedule · both | $117.75 | $97.73 | $37.67 – $117.75 |
| 6 | Humana medicare advantage professional · fee schedule · both | $117.75 | $97.73 | $37.67 – $117.75 |
| 7 | Tricare government professional · fee schedule · both | $117.75 | $97.73 | $37.67 – $117.75 |
| 8 | Anthem managed medicaid facility · fee schedule · outpatient | $104.21 | $104.21 | $104.21 – $104.21 |
| 9 | UnitedHealthcare commercial professional · fee schedule · both | $130.44 | $108.32 | $41.95 – $130.44 |
| 10 | Aetna medicare advantage facility · case rate · outpatient | $111.40 | $111.40 | $111.40 – $111.40 |
| 11 | Anthem medicare advantage facility · case rate · outpatient | $111.40 | $111.40 | $111.40 – $111.40 |
| 12 | Caresource medicare advantage facility · case rate · outpatient | $111.40 | $111.40 | $111.40 – $111.40 |
| 13 | Humana medicare advantage facility · case rate · outpatient | $111.40 | $111.40 | $111.40 – $111.40 |
| 14 | Anthem managed medicaid professional · fee schedule · both | $146.31 | $117.05 | $42.11 – $146.31 |
| 15 | Caresource commercial professional · fee schedule · both | $147.19 | $122.17 | $47.09 – $147.19 |
| 16 | Ambetter commercial professional · fee schedule · both | $153.08 | $127.05 | $48.97 – $153.08 |
| 17 | Caresource commercial facility · case rate · outpatient | $139.25 | $139.25 | $139.25 – $139.25 |
| 18 | Ambetter commercial facility · case rate · outpatient | $144.82 | $144.82 | $144.82 – $144.82 |
| 19 | Anthem hmo/ppo/traditional professional · fee schedule · both | $242.12 | $200.07 | $73.90 – $242.12 |
| 20 | Aetna commercial professional · fee schedule · both | $410.32 | $339.97 | $128.91 – $410.32 |
| 21 | Cigna commercial professional · fee schedule · both | $410.32 | $339.97 | $128.91 – $410.32 |
Last updated: Feb 13, 2026
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