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New Hampshire rates for HCPCS 70487

Computed tomography, maxillofacial area; with contrast material(s)

Facilitymedian $91 · 10th–90th $59$2400%20%10th90th$91Professionalmedian $158 · 10th–90th $59$3720%5%10th90th$158$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$58.88 / $91.20 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $263.03 / $549.54
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$51.29 / $81.28 / $186.21
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$97.72 / $186.21 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$67.61 / $67.61 / $173.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $363.08 / $562.34
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$52.48 / $120.23 / $173.78
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$100.00 / $234.42 / $371.54
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $363.08 / $758.58
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $102.33 / $162.18
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$131.83 / $245.47 / $537.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $269.15 / $416.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$60.26 / $95.50 / $138.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$117.49 / $190.55 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $295.12 / $549.54
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $85.11 / $162.18
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$117.49 / $181.97 / $338.84
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$39.81 / $43.65 / $52.48