CT head without contrast at Good Samaritan Hospital (GSH). CPT 70450.
What Good Samaritan Hospital (GSH) publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$869cash price (self-pay)
$1,449list price
$78.11–$1,580range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Advantage | $111 |
| Allwell | MCR ADV/PPO/HMO | $111 |
| Anthem MCR | MCR ADV/PPO/HMO | $111 |
| Anthem MCR | Medicare Advantage | $111 |
| Anthem | MCR ADV/PPO/HMO | $111 |
| Cigna | Medicare Advantage | $111 |
| Humana | Medicare Advantage | $111 |
| Indiana University | MCR ADV/PPO/HMO | $111 |
| MHS Ambetter | Commercial | $111 |
| Encore Prime | Commercial | $129 |
| Alliance Coal | Commercial | $166 |
| CareSource | Commercial | $166 |
| Aetna | Medicaid | $221 |
| Anthem HIP | HIP | $221 |
| Anthem Pathways | Medicaid | $221 |
| Anthem | Medicaid | $221 |
| BCBS | Medicare Advantage | $221 |
| Caresource HIP | Medicaid | $221 |
| Caresource | Medicaid | $221 |
| Meridian | Medicaid | $221 |
| Hope Trust | Commercial | $221 |
| Anthem | HealthSync | $667 |
| Amish | Commercial | $725 |
| Anthem | Exchange | $853 |
| United Healthcare | Commercial | $951 |
| Aetna | Commercial | $1,061 |
| Indiana University | Commercial | $1,104 |
| Direct Health | Direct Health | $1,111 |
| SIHO | Commercial | $1,111 |
| Cigna | Commercial | $1,145 |
Inpatient
$869cash price (self-pay)
$1,449list price
$843–$1,449range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Exchange | $843 |
| United Healthcare | Commercial | $959 |
| Anthem | Trad/PPO/HMO | $1,054 |
| Direct Health | Direct Health | $1,111 |
| SIHO | Commercial | $1,111 |
| Cigna | Commercial | $1,145 |
| Sagamore | Commercial | $1,145 |
| Corvel | Workers Comp | $1,188 |
| Aetna | Commercial | $1,214 |
| Anthem | HealthSync | $1,246 |
| HealthLink | HMO | $1,275 |
| Encore Prime | Commercial | $1,304 |
| Humana | Commercial | $1,304 |
| HealthLink | PPO | $1,348 |
| Molina | Medicaid | $1,449 |
| Underwriters Safety | Commercial | $1,449 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.