CT scan of face and jaw without contrast dye at Santa Rosa Hospital - Westover Hills

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 70486 CT MAXLFCL AREA W/O CONTRAST

San Antonio, TX

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How this price compares nationally

Santa Rosa Hospital - Westover Hills’s median price of $135 is 58% below the median hospital's median price ($321), higher than 19% of the 2,630 hospitals reporting CPT 70486. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 70486 at Santa Rosa Hospital - Westover Hills

Negotiated rates from the hospital’s own file: 12 payers, 35 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	Aetna mm fee schedule · outpatient	$99.85	$99.85	$99.85 – $99.85
2	Bcbs Tx mm fee schedule · outpatient	$99.85	$99.85	$99.85 – $99.85
3	Humana gold choice mm fee schedule · outpatient	$99.85	$99.85	$99.85 – $99.85
4	Humana gold plus mm fee schedule · outpatient	$99.85	$99.85	$99.85 – $99.85
5	Molina medicare adv mm fee schedule · outpatient	$99.85	$99.85	$99.85 – $99.85
6	UnitedHealthcare mm fee schedule · outpatient	$99.85	$99.85	$99.85 – $99.85
7	WellCare mm fee schedule · outpatient	$99.85	$99.85	$99.85 – $99.85
8	Devoted mm fee schedule · outpatient	$107.84	$107.84	$107.84 – $107.84
9	UnitedHealthcare chip km fee schedule · outpatient	$114.46	$114.46	$114.46 – $114.46
10	UnitedHealthcare star km fee schedule · outpatient	$114.46	$114.46	$114.46 – $114.46
11	UnitedHealthcare star plus km fee schedule · outpatient	$114.46	$114.46	$114.46 – $114.46
12	Aetna chip km fee schedule · outpatient	$134.67	$134.67	$134.67 – $134.67
13	Aetna star km fee schedule · outpatient	$134.67	$134.67	$134.67 – $134.67
14	Bcbs Tx star chip km fee schedule · outpatient	$134.67	$134.67	$134.67 – $134.67
15	Molina chip km fee schedule · outpatient	$134.67	$134.67	$134.67 – $134.67
16	Molina star plus km fee schedule · outpatient	$134.67	$134.67	$134.67 – $134.67
17	Bcbs Tx blue advantangehmo fee schedule · outpatient	$314.94	$314.94	$314.94 – $314.94
18	Bcbs Tx hmo fee schedule · outpatient	$386.68	$386.68	$386.68 – $386.68
19	Bcbs Tx heb fee schedule · outpatient	$391.16	$391.16	$391.16 – $391.16
20	Bcbs Tx ppo fee schedule · outpatient	$434.87	$434.87	$434.87 – $434.87
21	Bcbs Tx traditional fee schedule · outpatient	$457.29	$457.29	$457.29 – $457.29
22	First Health hmo other · outpatient	$673.00	$673.00	$673.00 – $673.00
23	Humana choicecare fee schedule · outpatient	$779.00	$779.00	$779.00 – $779.00
24	Aetna new business per diem · outpatient	$821.00	$821.00	$821.00 – $821.00
25	UnitedHealthcare all payer fee schedule · outpatient	$855.00	$855.00	$855.00 – $855.00

Page 1 of 2 · 35 rates

Last updated: Jan 13, 2026

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