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.
Original text from hospital filings
CT Maxillofacial W Contrast
Sioux Center, IA
See all hospitals reporting CPT 70487 →Price type
Sioux Center Health’s median price of $268 is 37% below the median hospital's median price ($427), higher than 32% of the 2,577 hospitals reporting CPT 70487. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 16 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 | Wellmark hmo fee schedule · both | $102.00 | $102.00 | $102.00 – $102.00 |
| 2 | UnitedHealthcare com fee schedule · both | $104.71 | $104.71 | $104.71 – $104.71 |
| 3 | Medica com fee schedule · both | $114.29 | $114.29 | $114.29 – $114.29 |
| 4 | Medica ind fee schedule · both | $114.29 | $114.29 | $114.29 – $114.29 |
| 5 | Wellmark ppo fee schedule · both | $120.00 | $120.00 | $120.00 – $120.00 |
| 6 | Healthpartners com fee schedule · both | $120.23 | $120.23 | $120.23 – $120.23 |
| 7 | Medica com fee schedule · outpatient | $268.29 | $268.29 | $268.29 – $268.29 |
| 8 | Medica ind fee schedule · outpatient | $268.29 | $268.29 | $268.29 – $268.29 |
| 9 | Medica ind percent of total billed charges · inpatientfrom % of charges | $795.60 | $795.60 | $795.60 – $795.60 |
| 10 | Wellmark hmo case rate · outpatient | $916.24 | $916.24 | $916.24 – $916.24 |
| 11 | Wellmark ppo case rate · outpatient | $916.24 | $916.24 | $916.24 – $916.24 |
| 12 | Medica com percent of total billed charges · inpatientfrom % of charges | $944.93 | $944.93 | $944.93 – $944.93 |
| 13 | UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges | $1,044 | $1,044 | $1,044 – $1,044 |
| 14 | UnitedHealthcare com percent of total billed charges · outpatientfrom % of charges | $1,044 | $1,044 | $1,044 – $1,044 |
| 15 | Healthpartners com percent of total billed charges · inpatientfrom % of charges | $1,126 | $1,126 | $1,126 – $1,126 |
| 16 | Healthpartners com percent of total billed charges · outpatientfrom % of charges | $1,126 | $1,126 | $1,126 – $1,126 |
Last updated: Apr 1, 2026
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