CT scan of face and jaw with contrast dye at Medical City Arlington

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

CT MAXIFAC W/CONTRAST

RED OAK, TX

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Pricing by billing methodology

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How this price compares nationally

Medical City Arlington’s median price of $584 is 37% above the median hospital's median price ($427), higher than 59% 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 Medical City Arlington

Negotiated rates from the hospital’s own file: 10 payers, 42 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 chip fee schedule · outpatient	$156.38	$156.38	$156.38 – $156.38
2	UnitedHealthcare star fee schedule · outpatient	$156.38	$156.38	$156.38 – $156.38
3	UnitedHealthcare starkids fee schedule · outpatient	$156.38	$156.38	$156.38 – $156.38
4	UnitedHealthcare starperinate fee schedule · outpatient	$156.38	$156.38	$156.38 – $156.38
5	UnitedHealthcare starplus fee schedule · outpatient	$156.38	$156.38	$156.38 – $156.38
6	Cigna Healthspring mgmcd fee schedule · outpatient	$164.20	$164.20	$164.20 – $164.20
7	Aetna Better Health chip fee schedule · outpatient	$168.89	$168.89	$168.89 – $168.89
8	Aetna Better Health mcd fee schedule · outpatient	$168.89	$168.89	$168.89 – $168.89
9	Molina chip fee schedule · outpatient	$173.59	$173.59	$172.02 – $175.15
10	Molina mcdstar fee schedule · outpatient	$173.59	$173.59	$172.02 – $175.15
11	Molina star+plus fee schedule · outpatient	$173.59	$173.59	$172.02 – $175.15
12	Molina starkids fee schedule · outpatient	$173.59	$173.59	$172.02 – $175.15
13	Humana mgmcd fee schedule · outpatient	$195.47	$195.47	$195.47 – $195.47
14	Blue Cross Blue Shield bluepremier fee schedule · outpatient	$216.84	$216.84	$216.84 – $216.84
15	Blue Cross Blue Shield blueadvantagehmo fee schedule · outpatient	$229.60	$229.60	$229.60 – $229.60
16	Blue Cross Blue Shield mybluehealth fee schedule · outpatient	$229.60	$229.60	$229.60 – $229.60
17	UnitedHealthcare narrownetworkindivexchange fee schedule · outpatient	$341.20	$341.20	$341.20 – $341.20
18	UnitedHealthcare smallgroup fee schedule · outpatient	$341.20	$341.20	$341.20 – $341.20
19	UnitedHealthcare allpayerappendix fee schedule · outpatient	$401.74	$401.74	$401.74 – $401.74
20	Humana comm fee schedule · outpatient	$447.02	$447.02	$447.02 – $447.02
21	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$450.23	$450.23	$450.23 – $450.23
22	Superior Healthplan mcdstar percent of total billed charges · outpatientfrom % of charges	$450.23	$450.23	$450.23 – $450.23
23	Superior Healthplan starhealth percent of total billed charges · outpatientfrom % of charges	$450.23	$450.23	$450.23 – $450.23
24	Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges	$450.23	$450.23	$450.23 – $450.23
25	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$450.23	$450.23	$450.23 – $450.23

Page 1 of 2 · 42 rates

Last updated: Mar 1, 2026

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