CT scan of face and jaw with 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/dye

Pittsfield, ME

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How this price compares nationally

Sebasticook Valley Health’s median price of $138 is 68% below the median hospital's median price ($427), higher than 4% 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 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	$58.31	$58.31	$58.31 – $58.31
2	UnitedHealthcare mcr advantage facility · case rate · outpatient	$58.31	$58.31	$58.31 – $58.31
3	WellCare mcr advantage facility · case rate · outpatient	$58.31	$58.31	$58.31 – $58.31
4	Anthem mcr advantage facility · case rate · outpatient	$58.89	$58.89	$58.89 – $58.89
5	Aetna mcr advantage professional · fee schedule · outpatient	$69.66	$69.66	$49.71 – $89.61
6	Anthem mcr advantage professional · fee schedule · outpatient	$69.66	$69.66	$49.71 – $89.61
7	UnitedHealthcare mcr advantage professional · fee schedule · outpatient	$71.05	$71.05	$50.70 – $91.40
8	WellCare mcr advantage professional · fee schedule · outpatient	$71.05	$71.05	$50.70 – $91.40
9	Aetna mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$80.94	$80.94	$80.94 – $80.94
10	Anthem mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$80.94	$80.94	$80.94 – $80.94
11	UnitedHealthcare mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$80.94	$80.94	$80.94 – $80.94
12	WellCare mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$80.94	$80.94	$80.94 – $80.94
13	Aetna commercial professional · fee schedule · outpatient	$121.91	$121.91	$86.99 – $156.82
14	Anthem commercial professional · percent of total billed charges · inpatientfrom % of charges	$138.45	$138.45	$138.45 – $138.45
15	Anthem commercial professional · percent of total billed charges · outpatientfrom % of charges	$138.45	$138.45	$138.45 – $138.45
16	Anthem enhanced pathways professional · percent of total billed charges · inpatientfrom % of charges	$138.45	$138.45	$138.45 – $138.45
17	Anthem enhanced pathways professional · percent of total billed charges · outpatientfrom % of charges	$138.45	$138.45	$138.45 – $138.45
18	UnitedHealthcare commercial professional · fee schedule · outpatient	$138.62	$138.62	$97.37 – $179.87
19	Aetna commercial professional · percent of total billed charges · outpatientfrom % of charges	$143.78	$143.78	$143.78 – $143.78
20	Anthem commercial professional · fee schedule · outpatient	$145.27	$145.27	$99.77 – $190.76
21	Anthem enhanced pathways professional · fee schedule · outpatient	$145.27	$145.27	$99.77 – $190.76
22	UnitedHealthcare commercial professional · percent of total billed charges · inpatientfrom % of charges	$154.42	$154.42	$154.42 – $154.42
23	Cigna commercial professional · percent of total billed charges · inpatientfrom % of charges	$158.90	$158.90	$158.90 – $158.90
24	Cigna commercial professional · percent of total billed charges · outpatientfrom % of charges	$158.90	$158.90	$158.90 – $158.90
25	Aetna commercial professional · percent of total billed charges · inpatientfrom % of charges	$159.75	$159.75	$159.75 – $159.75

Page 1 of 2 · 45 rates

Last updated: Mar 30, 2026

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