CT head without contrast at Jacksonville Memorial Hospital. CPT 70450.
What Jacksonville Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 17, 2026.
Outpatient / ER
$3,138cash price (self-pay)
$3,423list price
$8.77–$3,707range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Blue Shield | Blue Cross Community MMAI/Dual Eligible | $277 |
| Coventry | Coventry Advantra Medicare Advantage HMO | $297 |
| Health Alliance | Health Alliance Medicare Advantage | $297 |
| Humana | Humana/ChoiceCare Medicare Advantage PPO/HMO | $297 |
| Medicare | Medicare | $297 |
| United HealthCare | United HealthCare Medicare Advantage | $312 |
| Tricare | Tricare | $336 |
| Commercial Workers Compensation | Commercial Workers Compensation | $499 |
| WellCare Medicare Advantage PPO | WellCare Medicare Advantage PPO | $539 |
| UHC Va Ccn | UHC Va Ccn | $548 |
| Medicaid | Illinois Medicaid | $595 |
| Molina HealthCare | Molina Medicaid | $595 |
| Corvel/CorCare | Corvel/CorCare | $882 |
| Illinois Workers Compensation | Illinois Workers Compensation | $959 |
| Health Alliance MH Employee plan | Health Alliance MH Employee plan | $1,574 |
| Healthlink | Healthlink HMO | $1,859 |
| Health Alliance | Health Alliance Fully Insured/Self Funded/ACA | $1,889 |
| 6 Degrees Health | 6 Degrees Health | $2,054 |
| Hope Trust | Hope Trust | $2,054 |
| Hst | Hst | $2,054 |
| Cigna | Cigna | $2,372 |
| United Healthcare | United Healthcare PPO | $2,464 |
| Aetna | Aetna PPO | $2,551 |
| Current Health Network | Current Health Network | $2,567 |
| Humana/ChoiceCare | Humana/ChoiceCare | $2,919 |
| PHCS/Multiplan | PHCS/Multiplan PPO | $3,080 |
| Hfn | Hfn PPO | $3,251 |
| HFN | HFN Workers Compensation | $3,251 |
| Blue Cross Blue Shield | BCBS PPO/HMO/Employee | $3,423 |
| Liability | Liability | $3,423 |
Inpatient
$3,138cash price (self-pay)
$3,423list price
$1,443–$3,707range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Alliance MH Employee plan | Health Alliance MH Employee plan | $1,574 |
| Current Health Network | Current Health Network | $1,882 |
| 6 Degrees Health | 6 Degrees Health | $2,054 |
| Hope Trust | Hope Trust | $2,054 |
| Hst | Hst | $2,054 |
| Cigna | Cigna | $2,372 |
| Aetna | Aetna PPO | $2,392 |
| Humana/ChoiceCare | Humana/ChoiceCare | $2,919 |
| Hfn | Hfn PPO | $3,251 |
| HFN | HFN Workers Compensation | $3,251 |
| Blue Cross Blue Shield | BCBS PPO/HMO/Employee | $3,423 |
| Liability | Liability | $3,423 |
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