CT head without contrast at Mount St. Mary's Hospital. CPT 70450.

What Mount St. Mary's Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.

Outpatient / ER

$72.00cash price (self-pay)

$852list price

$26.89–$852range insurers pay

Insurance plan	Negotiated rate
Univera Healthcare Essential [100170] \| Univera Essential Plan 3 And 4	$72.72
Tuscarora Nation [550120] \| Tuscarora Nation Plan [55012005]	$72.72
Amerigroup [350102] \| BCBS Amerigroup Mcd [35010203]	$72.72
Beacon Essential [350122] \| Beacon Essential Plan 3 And 4 [35012202]	$72.72
Medicaid Out Of State [309999] \| Medicaid Virginia [30999913]	$72.72
Molina Medicaid [350107] \| Affinity Molina Chp Non-Medicaid [35010704]	$72.72
Univera Healthcare Medicaid [350108] \| Child Health Plus Univera Medic	$72.72
Amerigroup [350102] \| Chp BCBS Amg Non Mcd [35010202]	$72.72
Medicaid In State [300001] \| Medicaid Episodic [30000103]	$72.72
Medicaid Out Of State [309999] \| Medicaid Florida [30999905]	$72.72
Amerigroup Medicaid [350002] \| Amerigroup Medicaid [35000201]	$72.72
Univera Healthcare Essential [100170] \| Univera Essential Plan 1 And 2	$87.26
Aetna [100001] \| Aetna Other Commercial [10000109]	$128
Independent Health Medicare [450122] \| Family Choice [45012203]	$130
Independent Health Medicare [450122] \| Mcr Passport Advantage [4501220	$130
Independent Health Medicare [450122] \| Medicare PPO Iha [45012202]	$130
United Healthcare Essential [100253] \| UHC Essential 1 And 2 [10025301	$164
BCBS Essential [100152] \| Bc Essential Plan 1 And 2 [10015201]	$164
Molina Essential [100167] \| Molina Essential Plan 200-250 [10016706]	$164
Independent Health [100165] \| Iha Passport [10016507]	$208
Independent Health [100165] \| Iha Encompass [10016503]	$216
No Fault [114001] \| Nationwide Ins [11400107]	$302
No Fault [114001] \| Usaa [11500101]	$302
Workers Compensation [500101] \| Aig Claims [50010104]	$302
WORKERS COMPENSATION [500101] \| CORVEL Single Payer ID [5005003]	$302
Workers Compensation [500101] \| Em Risk Management [50010105]	$302
Workers Compensation [500101] \| Esis [50010116]	$302
Workers Compensation [500101] \| First Niagara Risk [50010109]	$302
Workers Compensation [500101] \| Gallagher Bassett [50010107]	$302
Workers Compensation [500101] \| Jag Source [50010124]	$302

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All common services at Mount St. Mary's Hospital