CT scan of face and jaw without contrast dye at Sebasticook Valley Health

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 maxillofacial w/o dye

Pittsfield, ME

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How this price compares nationally

Sebasticook Valley Health’s median price of $106 is 67% below the median hospital's median price ($321), higher than 7% 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 Sebasticook Valley Health

Negotiated rates from the hospital’s own file: 5 payers, 45 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 mcr advantage facility · case rate · outpatient	$44.33	$44.33	$44.33 – $44.33
2	UnitedHealthcare mcr advantage facility · case rate · outpatient	$44.33	$44.33	$44.33 – $44.33
3	WellCare mcr advantage facility · case rate · outpatient	$44.33	$44.33	$44.33 – $44.33
4	Anthem mcr advantage facility · case rate · outpatient	$44.76	$44.76	$44.76 – $44.76
5	Aetna mcr advantage professional · fee schedule · outpatient	$58.58	$58.58	$37.79 – $79.36
6	Anthem mcr advantage professional · fee schedule · outpatient	$58.58	$58.58	$37.79 – $79.36
7	UnitedHealthcare mcr advantage professional · fee schedule · outpatient	$59.75	$59.75	$38.55 – $80.95
8	WellCare mcr advantage professional · fee schedule · outpatient	$59.75	$59.75	$38.55 – $80.95
9	Aetna mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$61.94	$61.94	$61.94 – $61.94
10	Anthem mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$61.94	$61.94	$61.94 – $61.94
11	UnitedHealthcare mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$61.94	$61.94	$61.94 – $61.94
12	WellCare mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$61.94	$61.94	$61.94 – $61.94
13	Aetna commercial professional · fee schedule · outpatient	$102.51	$102.51	$66.13 – $138.88
14	Anthem commercial professional · percent of total billed charges · inpatientfrom % of charges	$105.95	$105.95	$105.95 – $105.95
15	Anthem commercial professional · percent of total billed charges · outpatientfrom % of charges	$105.95	$105.95	$105.95 – $105.95
16	Anthem enhanced pathways professional · percent of total billed charges · inpatientfrom % of charges	$105.95	$105.95	$105.95 – $105.95
17	Anthem enhanced pathways professional · percent of total billed charges · outpatientfrom % of charges	$105.95	$105.95	$105.95 – $105.95
18	Aetna commercial professional · percent of total billed charges · outpatientfrom % of charges	$110.02	$110.02	$110.02 – $110.02
19	UnitedHealthcare commercial professional · fee schedule · outpatient	$114.98	$114.98	$73.68 – $156.27
20	UnitedHealthcare commercial professional · percent of total billed charges · inpatientfrom % of charges	$118.18	$118.18	$118.18 – $118.18
21	Cigna commercial professional · percent of total billed charges · inpatientfrom % of charges	$121.60	$121.60	$121.60 – $121.60
22	Cigna commercial professional · percent of total billed charges · outpatientfrom % of charges	$121.60	$121.60	$121.60 – $121.60
23	Aetna commercial professional · percent of total billed charges · inpatientfrom % of charges	$122.25	$122.25	$122.25 – $122.25
24	Anthem commercial professional · fee schedule · outpatient	$122.37	$122.37	$75.93 – $168.80
25	Anthem enhanced pathways professional · fee schedule · outpatient	$122.37	$122.37	$75.93 – $168.80

Page 1 of 2 · 45 rates

Last updated: Mar 30, 2026

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