CT head without contrast at Mercy Pediatrics - Carthage. CPT 70450.
What Mercy Pediatrics - Carthage publishes for this service, straight from its standard-charges file, last updated June 12, 2026.
Outpatient / ER
$77.25cash price (self-pay)
$175list price
$26.73–$278range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AETNA MEDICAID [20009] | PB OK,AR,SGF,JOPL OK MCD ADVANTAGE Plans | $55.30 |
| Aetna Medicaid Contracted [320009] | Pb Ok,Ar,Sgf,Jopl Ok Mcd Advantag | $55.30 |
| HUMANA MEDICAID [20486] | PB OK,AR,SGF,JOPL OK MCD ADVANTAGE Plans | $55.30 |
| Humana Medicaid Contracted [320486] | Pb Ok,Ar,Sgf,Jopl Ok Mcd Advanta | $55.30 |
| Aetna Medicare Advantage [20010] | Pb Sprg/Jopl Aetna Medicare-Missou | $58.20 |
| Aetna Medicare Advantage [20010] | Pb Sprg/Jopl/Cape/Stod Medicare Mo | $58.20 |
| Aetna Medicare Advantage Contracted [320010] | Pb Sprg/Jopl Aetna Med | $58.20 |
| BCBS Medicare Advantage Contracted [320047] | Pb Sprg/Jopl Blue Cross | $58.20 |
| Humana Medicare Advantage Contracted [320194] | Pb Sprg/Jopl/Ks Humana | $58.20 |
| Devoted Health Medicare Contracted [320500] | Pb Sprg-Jopl Devoted Hea | $60.53 |
| Humana Contracted [320193] | Pb Jopl Humana/Ppox | $69.84 |
| Blue Cross And Blue Shield [20053] | Pb Sprg/Jopl Anthem Alliance Outs | $76.27 |
| Mc Anthem [20455] | Pb Sprg/Jopl Anthem Alliance Outside Greene County | $76.27 |
| United Healthcare Contracted [320396] | Pb Sprg/Jopl United Healthcare | $76.68 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Pathways X (E | $78.50 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Blue Preferre | $79.19 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Blue Access | $80.98 |
| Mc Generic Anthem [20456] | Pb Sprg Jopl Anthem Blue Access | $80.98 |
| Healthlink Contracted [320179] | Pb Sprg/Jopl Healthlink | $84.48 |
| Auxiant Contracted [320462] | Pb Sprg-Jopl Buchheit Dec | $87.88 |
| Health Choice Contracted [320166] | Pb Jopl Healthchoice | $89.87 |
| Home State Health Plan Contracted [320187] | Pb Jopl Homestate/Novasys | $96.05 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $96.25 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $96.25 |
| Boon Chapman Contracted [320055] | Pb Jopl Krey Distributing | $96.25 |
| Healthsmart Preferred Care Contracted [320184] | Pb Sprg/Jopl Arvest B | $96.25 |
| Aetna [20008] | Pb Sprg/Jopl Aetna-Coventry | $103 |
| Aetna Contracted [320008] | Pb Sprg/Jopl Aetna-Coventry | $103 |
| Healthcare Highways Plus Contracted [320175] | Pb Sprg/Jopl Aetna-Cove | $103 |
| Medica [20239] | Pb Sprg-Jopl Medica | $104 |
Inpatient
$77.25cash price (self-pay)
$175list price
$26.73–$278range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AETNA MEDICAID [20009] | PB OK,AR,SGF,JOPL OK MCD ADVANTAGE Plans | $55.30 |
| Aetna Medicaid Contracted [320009] | Pb Ok,Ar,Sgf,Jopl Ok Mcd Advantag | $55.30 |
| HUMANA MEDICAID [20486] | PB OK,AR,SGF,JOPL OK MCD ADVANTAGE Plans | $55.30 |
| Humana Medicaid Contracted [320486] | Pb Ok,Ar,Sgf,Jopl Ok Mcd Advanta | $55.30 |
| Aetna Medicare Advantage [20010] | Pb Sprg/Jopl Aetna Medicare-Missou | $58.20 |
| Aetna Medicare Advantage [20010] | Pb Sprg/Jopl/Cape/Stod Medicare Mo | $58.20 |
| Aetna Medicare Advantage Contracted [320010] | Pb Sprg/Jopl Aetna Med | $58.20 |
| BCBS Medicare Advantage Contracted [320047] | Pb Sprg/Jopl Blue Cross | $58.20 |
| Humana Medicare Advantage Contracted [320194] | Pb Sprg/Jopl/Ks Humana | $58.20 |
| Devoted Health Medicare Contracted [320500] | Pb Sprg-Jopl Devoted Hea | $60.53 |
| Humana Contracted [320193] | Pb Jopl Humana/Ppox | $69.84 |
| Blue Cross And Blue Shield [20053] | Pb Sprg/Jopl Anthem Alliance Outs | $76.27 |
| Mc Anthem [20455] | Pb Sprg/Jopl Anthem Alliance Outside Greene County | $76.27 |
| United Healthcare Contracted [320396] | Pb Sprg/Jopl United Healthcare | $76.68 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Pathways X (E | $78.50 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Blue Preferre | $79.19 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Blue Access | $80.98 |
| Mc Generic Anthem [20456] | Pb Sprg Jopl Anthem Blue Access | $80.98 |
| Healthlink Contracted [320179] | Pb Sprg/Jopl Healthlink | $84.48 |
| Auxiant Contracted [320462] | Pb Sprg-Jopl Buchheit Dec | $87.88 |
| Health Choice Contracted [320166] | Pb Jopl Healthchoice | $89.87 |
| Home State Health Plan Contracted [320187] | Pb Jopl Homestate/Novasys | $96.05 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $96.25 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $96.25 |
| Boon Chapman Contracted [320055] | Pb Jopl Krey Distributing | $96.25 |
| Healthsmart Preferred Care Contracted [320184] | Pb Sprg/Jopl Arvest B | $96.25 |
| Aetna [20008] | Pb Sprg/Jopl Aetna-Coventry | $103 |
| Aetna Contracted [320008] | Pb Sprg/Jopl Aetna-Coventry | $103 |
| Healthcare Highways Plus Contracted [320175] | Pb Sprg/Jopl Aetna-Cove | $103 |
| Medica [20239] | Pb Sprg-Jopl Medica | $104 |
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