CT scan of face and jaw with and without contrast at TMC Bonham Hospital

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 MAXILLO WO/W CON

Bonham, TX

See all payers reporting CPT 70488 →

Payers reporting CPT 70488 at TMC Bonham Hospital

Negotiated rates from the hospital’s own file: 8 payers, 13 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	Molina medicaid fee schedule · both	$303	$286	$40	14%	—	$232 – $324
2	Superior Healthplan medicaid fee schedule · both	$299	$299	$10	3%	—	$289 – $309
3	UnitedHealthcare medicaid fee schedule · both	$299	$299	$10	3%	—	$289 – $309
4	Aetna medicare percent of total billed charges · bothfrom % of charges	$576	$576	—	—	—	$576 – $576
5	Humana medicare percent of total billed charges · bothfrom % of charges	$576	$576	—	—	—	$576 – $576
6	UnitedHealthcare medicare percent of total billed charges · bothfrom % of charges	$576	$576	—	—	—	$576 – $576
7	Ambetter qhp percent of total billed charges · bothfrom % of charges	$904	$904	—	—	—	$904 – $904
8	Cigna hmo percent of total billed charges · bothfrom % of charges	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
9	Aetna ppo percent of total billed charges · bothfrom % of charges	$1.4k	$1.4k	—	—	—	$1.4k – $1.4k
10	Blue Cross Blue Shield hmo percent of total billed charges · bothfrom % of charges	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k
11	Blue Cross Blue Shield managed_care percent of total billed charges · bothfrom % of charges	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k
12	Blue Cross Blue Shield ppo percent of total billed charges · bothfrom % of charges	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k
13	Blue Cross Blue Shield qhp percent of total billed charges · bothfrom % of charges	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k