CT head without contrast at Gundersen St. Elizabeth Hospital and Clinics. CPT 70450.
What Gundersen St. Elizabeth Hospital and Clinics publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$1,186cash price (self-pay)
$1,948list price
$82.59–$2,721range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Medicaid | $82.59 |
| Group Health of South Central | Medicaid HMO | $82.59 |
| Iowa Total Care | Medicaid | $82.59 |
| Managed Health Service | Managed Medicaid | $82.59 |
| Quartz | Medicaid_Badgercare | $82.59 |
| South County | Managed Medicaid | $82.59 |
| Alliance | Premier/All Products | $427 |
| Alliance | Comprehensive/All Products | $427 |
| Bcbsmn | Mhcp | $482 |
| Medica | AccessAbilty Solution | $491 |
| Medica | Minnesota Care | $491 |
| Quartz | All Products | $824 |
| Quartz | All Other Self Funded | $857 |
| Quartz | Self Funded | $916 |
| Quartz | Level Funded | $945 |
| Health Partners | Medicaid HMO | $974 |
| Aetna | Medicare Advantage | $1,052 |
| Quartz | Fully Insured | $1,062 |
| Medica | Medicare Advantage | $1,071 |
| Health Partners | Medicare Cost | $1,169 |
| Anthem | Medicare HMO/PPO | $1,266 |
| Health Partners | Medicare Advantage | $1,266 |
| Humana | Medicare Advantage | $1,266 |
| Quartz | Medicare Advantage | $1,266 |
| South County | Managed Medicare | $1,266 |
| UCARE | Dually Eligible | $1,266 |
| UCARE | Non-Dually Eligible | $1,266 |
| BCBSMN | All Products | $1,341 |
| Group Health of South Central | All Products | $1,558 |
| Trilogy | All Products | $1,558 |
Inpatient
$1,186cash price (self-pay)
$1,948list price
$482–$1,870range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $1,147 |
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All common services at Gundersen St. Elizabeth Hospital and Clinics