CT head without contrast at Good Samaritan Hospital. CPT 70450.
What Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$19,448cash price (self-pay)
$19,448list price
$63.19–$19,448range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Santa Clara Family Health Plan | Medicaid | $63.19 |
| Physicians Medical Group | MCD | $94.42 |
| Anthem | Medi-Cal | $104 |
| Physician Health Network | MGMCD | $104 |
| United | AllPayerAppendix | $245 |
| Anthem | ExchangeEPO | $355 |
| Anthem | BlueConnection | $375 |
| Anthem | COMM | $375 |
| Blue Shield | COMM | $2,020 |
| Blue Shield | EPN | $2,020 |
| MedCare Partners | MGMCR | $2,917 |
| United | OptionsPPO | $4,959 |
| Aetna | AWH | $4,973 |
| Aetna | HMO | $5,074 |
| Aetna | PPO | $5,074 |
| United | GlobalBenefitPlan | $8,751 |
| NX Health Network | COMM | $11,669 |
| Sutter Select | COMM | $11,669 |
| MultiPlan | Primary | $12,641 |
| ChoiceCare Humana | COMM | $13,613 |
| First Health | COMM | $14,780 |
| Cigna BH | COMMBH | $15,558 |
| HealthSmart | WCOMP | $15,558 |
| Intercontinental Corporation | COMM | $15,558 |
| MultiPlan | Complementary | $15,558 |
| PHA Pacific Health Alliance | COMM | $15,558 |
| PPO Next | COMM | $15,558 |
| PPO Next | PPO | $15,558 |
| HealthSmart | COMM | $16,530 |
| First Health | WCOMP | $19,448 |
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