CT head without contrast at Samuel Mahelona Memorial Hospital. CPT 70450.
What Samuel Mahelona Memorial Hospital publishes for this service, straight from its standard-charges file, last updated June 15, 2026.
Outpatient / ER
$101cash price (self-pay)
$155list price
$40.08–$1,553range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AlohaCare | Medicare | $40.08 |
| Ohana Health Plan | Medicare | $40.08 |
| Devoted Health | Medicare | $44.09 |
| AlohaCare | Medicaid | $71.70 |
| Ohana Health Plan | Medicaid | $71.70 |
| Health Management Network | Commercial | $132 |
| Hawaii Medical Service Association | Commercial | $134 |
| UnitedHealthcare | Medicaid | $139 |
| Kaiser Permanente | Commercial | $242 |
| Hawaii Medical Service Association | Medicare | $247 |
| Kaiser Permanente | Medicare | $247 |
| UnitedHealthcare | Medicare | $247 |
| Hawaii Western Management Group | Commercial | $254 |
| Hawaii Medical Service Association | ABD | $287 |
| Hawaii Medical Service Association | Non-ABD | $302 |
| Kaiser Permanente | Medicaid | $434 |
| University Health Alliance | Commercial | $465 |
| Humana | Medicare | $801 |
| MDX Hawaii | PPO | $1,553 |
Inpatient
$1,041cash price (self-pay)
$1,601list price
$1,361–$1,553range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Management Network | Commercial | $1,361 |
| Kaiser Permanente | Commercial | $1,441 |
| MDX Hawaii | PPO | $1,553 |
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