CT head without contrast at Southeast Iowa Regional Medical Center West Burlington. CPT 70450.
What Southeast Iowa Regional Medical Center West Burlington publishes for this service, straight from its standard-charges file, last updated June 11, 2026.
Outpatient / ER
—cash price (self-pay)
$107list price
$31.03–$1,508range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| American Healthplan of Iowa - Midlevel | MEDICARE ADV. | $31.03 |
| Medicaid - Nurse Practitioner | MANAGED MEDICAID | $34.63 |
| Medicaid - Physician Assistant | MANAGED MEDICAID | $35.37 |
| Humana | MEDICARE ADV. | $38.96 |
| Aetna | FIRST HEALTH | $40.46 |
| American Healthplan of Iowa - MD | MEDICARE ADV. | $41.31 |
| Plain Church | ALL PRODUCTS | $69.55 |
| Wellmark Blue Cross - Anesthesiology | PPO | $77.00 |
| Wellmark Blue Cross - Pathologist | PPO | $77.00 |
| Wellmark Blue Cross - Physician | HMO | $77.00 |
| Wellmark Blue Cross - Physician Assistant | HMO | $77.00 |
| Wellmark Blue Cross - Physician Assistant | PPO | $77.00 |
| United Healthcare | ALL PRODUCTS | $77.92 |
| Midlands Choice | ALL PRODUCTS | $85.40 |
| Wellmark Blue Cross - Physician | PPO | $90.60 |
| Absolute Solutions | ALL PRODUCTS | $96.30 |
| First Agency | ALL PRODUCTS | $96.30 |
| Multiplan | ALL PRODUCTS | $96.30 |
| Henderson County | ALL PRODUCTS | $102 |
| Midlands Choice | All Products | $506 |
| Wellmark Blue Cross | HMO | $880 |
| Wellpoint (Amerigroup) | Managed Medicaid | $908 |
| Wellmark Blue Cross | PPO | $967 |
| Immugrun | All Products | $1,021 |
| Brighton Amish Church | All Products | $1,054 |
| Plain Church | All Products | $1,054 |
| 6 Degree | All Products | $1,297 |
| Geha | PPO | $1,508 |
Inpatient
—cash price (self-pay)
$1,621list price
$908–$1,508range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Midlands Choice | All Products | $1,459 |
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All common services at Southeast Iowa Regional Medical Center West Burlington