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
Ct maxillofacial w/o dye
Lebanon, NH
See all hospitals reporting CPT 70486 →Price type
Mary Hitchcock Memorial Hospital’s median price of $213 is 33% below the median hospital's median price ($321), higher than 38% 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: 10 payers, 102 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.
Filter by billing methodology
Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Anthem anthem - medicare advantage - dhp professional · fee schedule · outpatient | $47.52 | $47.52 | $39.36 – $55.68 |
| 2 | Bcbs Vt bcbs of vermont - medicare advantage - dhp professional · fee schedule · outpatient | $47.52 | $47.52 | $39.36 – $55.68 |
| 3 | UnitedHealthcare uhc - medicare advantage - dhp professional · fee schedule · outpatient | $47.52 | $47.52 | $39.36 – $55.68 |
| 4 | UnitedHealthcare uhc - va community care network - dhpn professional · fee schedule · outpatient | $47.52 | $47.52 | $39.36 – $55.68 |
| 5 | Aetna aetna medicare advantage - dhp professional · fee schedule · outpatient | $48.95 | $48.95 | $40.54 – $57.35 |
| 6 | WellCare wellcare - medicare advantage - dhp professional · fee schedule · outpatient | $49.42 | $49.42 | $40.93 – $57.90 |
| 7 | Ambetter ambetter commercial - exchange behavioral health - dhp professional · fee schedule · outpatient | $49.89 | $49.89 | $41.32 – $58.46 |
| 8 | Cigna cigna medicare advantage - dhp professional · fee schedule · outpatient | $57.35 | $63.50 | $40.54 – $92.62 |
| 9 | Amerihealth Caritas amerihealth caritas - nh managed medicaid - dhp professional · fee schedule · outpatient | $73.18 | $73.18 | $60.58 – $85.77 |
| 10 | UnitedHealthcare uhc - tiered freedom plan professional · fee schedule · outpatient | $78.84 | $78.84 | $48.05 – $109.63 |
| 11 | UnitedHealthcare uhc - freedom plan - dhp professional · fee schedule · outpatient | $87.60 | $87.60 | $53.39 – $121.81 |
| 12 | Ambetter ambetter commercial - exchange - dhpn professional · fee schedule · outpatient | $92.54 | $92.54 | $55.68 – $129.39 |
| 13 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · percent of total billed charges · outpatientfrom % of charges | $109.11 | $109.11 | $109.11 – $109.11 |
| 14 | Anthem anthem - medicare advantage facility · case rate · outpatient | $119.00 | $119.00 | $119.00 – $119.00 |
| 15 | Bcbs Vt bcbs of vermont - medicare advantage facility · case rate · outpatient | $119.00 | $119.00 | $119.00 – $119.00 |
| 16 | UnitedHealthcare uhc - medicare advantage facility · case rate · outpatient | $119.00 | $119.00 | $119.00 – $119.00 |
| 17 | UnitedHealthcare uhc - va community care network facility · case rate · outpatient | $119.00 | $119.00 | $119.00 – $119.00 |
| 18 | Aetna aetna medicare advantage facility · case rate · outpatient | $122.57 | $122.57 | $122.57 – $122.57 |
| 19 | Cigna cigna medicare advantage facility · case rate · outpatient | $122.57 | $122.57 | $122.57 – $122.57 |
| 20 | WellCare wellcare - medicare advantage facility · case rate · outpatient | $123.76 | $123.76 | $123.76 – $123.76 |
| 21 | UnitedHealthcare uhc - va community care network - dhps professional · fee schedule · outpatient | $129.29 | $129.29 | $129.29 – $129.29 |
| 22 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · fee schedule · outpatient | $148.81 | $148.81 | $148.81 – $148.81 |
| 23 | Ambetter ambetter commercial - exchange - dhps professional · fee schedule · outpatient | $153.34 | $153.34 | $93.36 – $213.31 |
| 24 | Ambetter ambetter commercial - exchange behavioral health facility · case rate · outpatient | $164.11 | $164.11 | $164.11 – $164.11 |
| 25 | Cigna cigna hmo-pos professional · fee schedule · outpatient | $167.61 | $167.61 | $102.14 – $233.08 |
Last updated: Jan 1, 2026
See CT scan of face and jaw without contrast dye pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.