CT head without contrast at Mercy Orthopedic Hospital Fort Smith. CPT 70450.
What Mercy Orthopedic Hospital Fort Smith publishes for this service, straight from its standard-charges file, last updated June 8, 2026.
Outpatient / ER
$1,075cash price (self-pay)
$1,654list price
$57.46–$1,700range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Provider Partners Health Plans Contracted [320450] | Hb Ftsm Managed M | $99.34 |
| Medica Medicare Advantage Contracted [320477] | Hb Ftsm Managed Medica | $99.34 |
| Prominence Health Plan Medicare Advantage Contracted [320496] | Hb Fts | $99.34 |
| United Healthcare Medicare Advantage Contracted [320398] | Hb Ftsm UHC | $99.34 |
| United Healthcare Contracted [320396] | Hb Ftsm Managed Medicare | $99.34 |
| United Behavioral Health Medicare Advantage Contracted [320392] | Hb F | $99.34 |
| Kindful Hospice Contracted [320434] | Hb Ftsm Managed Medicare | $99.34 |
| Elara Caring Aspire Hospice Contracted [320433] | Hb Ftsm Managed Medi | $99.34 |
| Halo Hcr Inc Hospice Contracted [320432] | Hb Ftsm Managed Medicare | $99.34 |
| Tricare Contracted [320380] | Hb Ftsm Tricare | $99.34 |
| Qual Choice Contracted [320325] | Hb Ftsm Managed Medicare | $99.34 |
| Nhc Advantage Medicare Contracted [320282] | Hb Ftsm Managed Medicare | $99.34 |
| Longevity Health Plan Medicare Contracted [320225] | Hb Ftsm Managed M | $99.34 |
| Humana Medicare Advantage Contracted [320194] | Hb Ftsm Humana Mcr | $99.34 |
| Globalhealth Contracted [320145] | Hb Ftsm Managed Medicare | $99.34 |
| Essence Healthcare Medicare Contracted [320122] | Hb Ftsm Managed Medi | $99.34 |
| Dept Of Veteran Affairs Contracted [320106] | Hb Ftsm Medicare | $99.34 |
| Cherokee Nation Health Serv Contracted [320066] | Hb Ftsm Medicare | $99.34 |
| Unicare Medicare [20384] | Hb Ftsm Managed Medicare | $99.34 |
| Tricare [20380] | Hb Ftsm Tricare | $99.34 |
| Tribute Health Plan Mcr [20338] | Hb Ftsm Managed Medicare | $99.34 |
| Windsor Medicare [20424] | Hb Ftsm Managed Medicare | $99.34 |
| University Pittsburgh Med Ctr Medicare [20407] | Hb Ftsm Managed Medic | $99.34 |
| American Health Advantage Of Mo Mcr [20264] | Hb Ftsm Managed Medicare | $99.34 |
| BCBS Medicare Advantage [20047] | Hb Ftsm Managed Medicare | $99.34 |
| Medicare [20244] | Hb Ftsm Medicare | $99.34 |
| Mental Health Network Medicare [20250] | Hb Ftsm Managed Medicare | $99.34 |
| Mercy Hospice Okc [20252] | Hb Ftsm Managed Medicare | $99.34 |
| Generic Medicare Managed Care [20137] | Hb Ftsm Managed Medicare | $99.34 |
| Horizons Medicare [20190] | Hb Ftsm Managed Medicare | $99.34 |
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