CT head without contrast at St. Luke's Jerome Standard Charges. CPT 70450.

What St. Luke's Jerome Standard Charges publishes for this service, straight from its standard-charges file, last updated March 25, 2026.

Outpatient / ER

$819cash price (self-pay)

$819list price

$117–$778range insurers pay

Insurance plan	Negotiated rate
Commercial [1028] \| Hb Mv Va Ccn	$117
Medicare Advantage Generic [1019] \| Hb Mv Medicare Advantage	$117
Medicare Advantage Generic [1019] \| Hb Mv Molina Mmcp	$117
Medicare Advantage Molina [1053] \| Hb Mv Molina Mmcp	$117
Medicare Advantage Pacificsource [1039] \| Hb Mv Pacificsource HMO PPO	$117
Medicare Advantage Pacificsource [1039] \| Hb Mv Slhp Pacificsource Med	$117
Medicare Advantage Regence [1016] \| Hb Mv Medicare Advantage	$117
Blue Cross/Medicare Advantage [1009] \| Hb Mv Bci True & Secure Med Adv	$118
Medicare Advantage Generic [1019] \| Hb Mv Molina Med Adv	$119
Medicare Advantage Molina [1053] \| Hb Mv Molina Med Adv	$119
Medicare Advantage UHC [1013] \| Hb Mv Aarp Optum Ubh Med Adv	$123
Medicare Advantage Aetna [1017] \| Hb Mv Aetna Med Adv	$128
Blue Cross Idaho [1007] \| Hb Mv Slhp Blue Cross Carepoint Qhp	$173
Commercial [1028] \| Hb Mv Slhp Mountain Health Coop	$173
Commercial [1028] \| Hb Mv Slhp Select Health Qhp	$173
Slplan Tap Mc St Lukes Health Plan [1641000001] \| Hb Mv Slhp St Lukes	$224
Blue Cross Idaho [1007] \| Hb Mv Slhp Blue Cross Large Group	$274
Commercial [1028] \| Hb Mv Slhp Select Health	$274
Blue Cross Out Of State [1041] \| Hb Mv Bci Out Of State	$398
Blue Shield Alt [100401] \| Hb Mv Regence Out Of State	$398
Commercial [1028] \| Hb Mv Regence PPO & Traditional	$398
Commercial [1028] \| Hb Mv H2b	$614
H2b [1068] \| Hb Mv H2b	$614
Blue Cross Federal [1008] \| Hb Mv Bci PPO Fep	$627
Blue Cross Idaho [1007] \| Hb Mv Bci PPO Fep	$627
Cigna [1062] \| Hb Mv Cigna	$655
Commercial [1028] \| Hb Mv Cigna	$655
Commercial [1028] \| Hb Mv Multiplan Primary Network	$655
Commercial [1028] \| Hb Mv Amps	$696
Commercial [1028] \| Hb Mv Christian Health Aid	$696

Inpatient

$1,361cash price (self-pay)

$1,361list price

$885–$1,293range insurers pay

Insurance plan	Negotiated rate
Slplan Tap Mc St Lukes Health Plan [1641000001] \| Hb Mv Slhp St Lukes	$885
Blue Cross Idaho [1007] \| Hb Mv Slhp Blue Cross Carepoint Qhp	$885
Blue Cross Idaho [1007] \| Hb Mv Slhp Blue Cross Large Group	$885
Commercial [1028] \| Hb Mv Slhp Mountain Health Coop	$885
Commercial [1028] \| Hb Mv Slhp Select Health	$885
Commercial [1028] \| Hb Mv Slhp Select Health Qhp	$885
Medicare Advantage Pacificsource [1039] \| Hb Mv Slhp Pacificsource Med	$885
Mountain Health Co-Op [1067] \| Hb Mv Slhp Mountain Health Coop	$885
Pacificsource [1020] \| Hb Mv Pacificsource Navigator Large Group	$885
Pacificsource [1020] \| Hb Mv Slhp Pacificsource Navigator Qhp	$885
Select Health [1063] \| Hb Mv Slhp Select Health	$885
Select Health [1063] \| Hb Mv Slhp Select Health Qhp	$885
St Lukes Health Plan [1046] \| Hb Mv Slhp St Lukes Health Plan Large Gr	$885
St Lukes Health Plan [1046] \| Hb Mv Slhp St Lukes Health Plan Qhp	$885
Commercial [1028] \| Hb Mv H2b	$1,021
H2b [1068] \| Hb Mv H2b	$1,021
Pacificsource [1020] \| Hb Mv Pacificsource PPO Voyager	$1,021
Aetna [1021] \| Hb Mv Bp Aetna	$1,089
Cigna [1062] \| Hb Mv Cigna	$1,089
Commercial [1028] \| Hb Mv Bp Aetna	$1,089
Commercial [1028] \| Hb Mv Cigna	$1,089
Commercial [1028] \| Hb Mv Multiplan Primary Network	$1,089
Commercial [1028] \| Hb Mv Va Ccn	$1,089
Providence [1022] \| Hb Mv Cigna	$1,089
Commercial [1028] \| Hb Mv Amps	$1,157
Commercial [1028] \| Hb Mv Christian Health Aid	$1,157
Commercial [1028] \| Hb Mv First Choice Health	$1,157
First Health [1064] \| Hb Mv First Choice Health	$1,157
Blue Cross Federal [1008] \| Hb Mv Bci PPO Fep	$1,164
Blue Cross Idaho [1007] \| Hb Mv Bci PPO Fep	$1,164

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All common services at St. Luke's Jerome Standard Charges