CT head without contrast at Dupont Hospital. CPT 70450.
What Dupont Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$326cash price (self-pay)
$2,908list price
$97.84–$2,617range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| NODE Tricare | NODE Tricare | $105 |
| Department of Veterans Affairs | NODE ChampVA | $111 |
| Anthem BCBS | Anthem IN Medicaid | $221 |
| CareSource | CareSource HHW IN Medicaid | $221 |
| CareSource | CareSource IN HIP | $221 |
| Humana PathWays IN Medicaid | Humana PathWays IN Medicaid | $221 |
| Medicaid | IN Medicaid | $221 |
| Medicaid Non-Par | IN Medicaid Non-Par | $221 |
| Managed Health Services | MHS HCC IN Medicaid | $221 |
| Managed Health Services | MHS HHW IN Medicaid | $221 |
| Managed Health Services | MHS IN HIP | $221 |
| PHP Freedom Network | PHP Freedom Network | $329 |
| Physicians Health Plan | PHP Options | $357 |
| Physicians Health Plan | PHP Classic Network | $403 |
| Lutheran Preferred | Lutheran Preferred Three Rivers Plus | $641 |
| Lutheran Preferred | Lutheran Preferred Exclusive Plus | $675 |
| Lutheran Network | Lutheran Preferred Exclusive Plus MRM | $675 |
| Lutheran Preferred | Lutheran Preferred Fixed | $675 |
| Lutheran Preferred | Lutheran Preferred Inclusive | $675 |
| Lutheran Preferred | Lutheran Preferred Three Rivers | $675 |
| Lutheran Preferred | Lutheran Preferred Exclusive | $709 |
| Amish Aid | Amish Aid | $785 |
| Encore PPO | Encore Combined PPO | $788 |
| Lutheran Preferred | Lutheran Preferred CHS Employees | $864 |
| Cigna | Cigna HMO | $939 |
| Cigna | Cigna PPO | $1,056 |
| Aetna | Aetna NBD | $1,076 |
| Aetna PSSD J and J | Aetna PSSD JJ | $1,076 |
| Physicians Health Plan | PHP Platinum Network | $1,126 |
| Aetna | Aetna | $1,300 |
Inpatient
$544cash price (self-pay)
$2,908list price
$359–$2,617range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Lutheran Preferred | Lutheran Preferred CHS Employees | $864 |
| Cigna | Cigna HMO | $939 |
| Cigna | Cigna PPO | $1,056 |
| Aetna | Aetna NBD | $1,076 |
| Aetna PSSD J and J | Aetna PSSD JJ | $1,076 |
| Physicians Health Plan | PHP Platinum Network | $1,126 |
| Aetna | Aetna | $1,300 |
| Self Pay | Self Pay | $1,309 |
| Medical Mutual of OH | Medical Mutual of Ohio | $1,541 |
| Lutheran Preferred | Lutheran Preferred Choice | $1,599 |
| Lutheran Preferred | Lutheran Preferred Exclusive | $1,599 |
| Lutheran Preferred | Lutheran Preferred CCSI | $1,745 |
| Prime Health Services | Prime Health Services | $2,181 |
| Prime Health Services | Prime Health Services Auto | $2,181 |
| FrontPath | FrontPath Health Coalition | $2,326 |
| Encore Health Network | Encore Fully Funded | $2,385 |
| Advantage Health Solutions | Advantage Health Solutions | $2,414 |
| Multiplan | Multiplan PPO Primary Network | $2,501 |
| Allied Benefit Systems | Allied Benefit Systems | $2,617 |
| Encore Health Network | Encore Self Funded | $2,617 |
| Multiplan | Multiplan PPO Complimentary Network | $2,617 |
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