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Washington rates for HCPCS 70487

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

Facilitymedian $100 · 10th–90th $60$1620%10%10th90th$100Professionalmedian $166 · 10th–90th $56$4170%5%10th90th$166$20.0$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
$60.26 / $87.10 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $275.42 / $933.25
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$51.29 / $87.10 / $288.40
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$100.00 / $190.55 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$39.81 / $85.11 / $104.71
Asuris Northwest Health
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $338.84 / $478.63
Asuris Northwest Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$74.13 / $112.20 / $158.49
Asuris Northwest Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$144.54 / $223.87 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $331.13 / $602.56
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$44.67 / $91.20 / $158.49
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$102.33 / $239.88 / $457.09
Kaiser Permanente
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$69.18 / $104.71 / $489.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $346.74 / $512.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $104.71 / $141.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$138.04 / $239.88 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $67.61
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $112.20 / $371.54
Premera BCBS
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$70.79 / $70.79 / $72.44
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $331.13 / $446.68
Premera BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$72.44 / $112.20 / $154.88
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$141.25 / $223.87 / $302.00
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $331.13 / $467.74
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$74.13 / $112.20 / $151.36
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$144.54 / $223.87 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $257.04 / $478.63
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$48.98 / $70.79 / $151.36
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$95.50 / $181.97 / $338.84
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $181.97 / $338.84
Wellpoint
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$56.23 / $60.26 / $107.15
Wellpoint
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$120.23 / $123.03 / $229.09