CT scan of face and jaw with contrast dye at MVHS, Inc.

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 Maxiollofacial W/Cont

Utica, NY

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Pricing by billing methodology

Price type

How this price compares nationally

MVHS, Inc.’s median price of $224 is 47% below the median hospital's median price ($427), higher than 23% 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 MVHS, Inc.

Negotiated rates from the hospital’s own file: 12 payers, 28 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	Excellus excellus bcbs medicaid fee schedule · outpatient	$146.45	$146.45	$146.45 – $146.45
2	Excellus excellus bcbs medicaid hmo fee schedule · outpatient	$146.45	$146.45	$146.45 – $146.45
3	Molina misc medicaid mco fee schedule · outpatient	$146.45	$146.45	$146.45 – $146.45
4	UnitedHealthcare uhc essential plan fee schedule · outpatient	$146.45	$146.45	$146.45 – $146.45
5	UnitedHealthcare uhc medicaid fee schedule · outpatient	$146.45	$146.45	$146.45 – $146.45
6	WellCare hb mvhs wellcare medicaid fee schedule · outpatient	$146.45	$146.45	$146.45 – $146.45
7	Humana humana military other · outpatient	$200.13	$200.13	$200.13 – $200.13
8	Tricare humana military other · outpatient	$200.13	$200.13	$200.13 – $200.13
9	Excellus excellus bcbs medicare advantage other · outpatient	$218.95	$218.95	$218.95 – $218.95
10	Humana humana medicare advantage other · outpatient	$218.95	$218.95	$218.95 – $218.95
11	Medicare medicare other · outpatient	$218.95	$218.95	$218.95 – $218.95
12	Optum vaccn optum other · outpatient	$218.95	$218.95	$218.95 – $218.95
13	UnitedHealthcare uhc medicare advantage other · outpatient	$221.14	$221.14	$221.14 – $221.14
14	Aetna aetna medicare advantage other · outpatient	$223.33	$223.33	$223.33 – $223.33
15	WellCare wellcare medicare advantage other · outpatient	$225.52	$225.52	$225.52 – $225.52
16	UnitedHealthcare uhc empire plan fee schedule · outpatient	$343.00	$343.00	$343.00 – $343.00
17	Cigna mvp and cigna commercial other · outpatient	$629.07	$629.07	$629.07 – $629.07
18	Excellus excellus bcbs medicaid percent of total billed charges · inpatientfrom % of charges	$925.31	$925.31	$925.31 – $925.31
19	UnitedHealthcare uhc empire plan percent of total billed charges · inpatientfrom % of charges	$1,400	$1,400	$1,400 – $1,400
20	UnitedHealthcare uhc commercial case rate · both	$1,595	$1,595	$1,595 – $1,595
21	Aetna aetna commercial percent of total billed charges · bothfrom % of charges	$2,087	$2,087	$2,087 – $2,087
22	Humana humana hmo/pos percent of total billed charges · inpatientfrom % of charges	$2,276	$2,276	$2,276 – $2,276
23	Bcbs Ny excellus bcbs indemnity percent of total billed charges · bothfrom % of charges	$2,384	$2,384	$2,384 – $2,384
24	Blue Cross Blue Shield excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges	$2,384	$2,384	$2,384 – $2,384
25	Excellus excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges	$2,384	$2,384	$2,384 – $2,384

Page 1 of 2 · 28 rates

Last updated: Aug 7, 2026

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