CT head without contrast at Kenmore Mercy Hospital. CPT 70450.
What Kenmore Mercy Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$72.00cash price (self-pay)
$423list price
$26.89–$852range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Univera Healthcare Essential [100170] | Univera Essential Plan 3 And 4 | $72.72 |
| Medicaid In State [300001] | Medicaid Episodic [30000103] | $72.72 |
| Medicaid Out Of State [309999] | Medicaid Florida [30999905] | $72.72 |
| Univera Healthcare Medicaid [350108] | Child Health Plus Univera Non M | $72.72 |
| Univera Healthcare Medicaid [350108] | Univera Mcd Myhealth [35010802] | $72.72 |
| Beacon Medicaid Replacement Alt [350124] | Beacon Medicaid Alt [350124 | $72.72 |
| Kalos Medicaid [350111] | Kalos Mltc [35011101] | $72.72 |
| Medicaid In State [300001] | Nys Medical Assistance [30000102] | $72.72 |
| Medicaid In State Alt Payer [300002] | School Medicaid Alt [30000201] | $72.72 |
| Medicaid Out Of State [309999] | Medicaid Massachusetts [30999906] | $72.72 |
| Beacon Medicaid Replacement Alt [350124] | Beacon Essential 3 And 4 Al | $72.72 |
| Crime Victims [100176] | Crime Victims [10017601] | $72.72 |
| Fidelis Medicaid [350105] | Fidelis Mltc [35010504] | $72.72 |
| Medicaid Out Of State [309999] | Medicaid North Carolina [30999909] | $72.72 |
| Medicaid Out Of State [309999] | Medicaid Out Of State [30999901] | $72.72 |
| Medicaid Out Of State [309999] | Medicaid Virginia [30999913] | $72.72 |
| Tuscarora Nation [550120] | Tuscarora Nation Plan [55012005] | $72.72 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 1 And 2 | $87.26 |
| Independent Health Medicaid [350106] | Medisource [35010601] | $87.66 |
| Independent Health Medicaid [350106] | Child Health Plus Iha Medicaid | $87.66 |
| Wellpoint Bc Medicaid [351102] | Wellpoint Bc Chp Medicaid [35110202] | $100 |
| Aetna [100001] | Aetna Other Commercial [10000109] | $128 |
| Magnacare [100142] | Magnacare [10014201] | $128 |
| Fidelis Essential [100163] | Fidelis Essential Plan 3 And 4 [10016302] | $153 |
| United Healthcare Essential [100253] | UHC Essential 3 And 4 [10025302 | $164 |
| Molina Essential [100167] | Molina Essential Plan 3 And 4 [10016702] | $164 |
| Molina Essential [100167] | Affinity Molina Essential Plan 1 And 2 [10 | $164 |
| Molina Essential [100167] | Affinity Molina Essential Plan 3 And 4 [10 | $164 |
| Independent Health [100165] | Choice Plus [10016505] | $208 |
| Independent Health [100165] | Iha Article 43 [10016502] | $208 |
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