CT head without contrast at Intermountain Health Primary Children's Hospital. CPT 70450.
What Intermountain Health Primary Children's Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$670cash price (self-pay)
$893list price
$39.70–$786range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Plan of Nevada | Medicaid | $51.82 |
| Healthy U | Medicaid | $60.80 |
| Molina | Medicaid | $60.80 |
| SelectHealth | Medicaid | $63.18 |
| American Health | Medicare Adv UT HMO I-SNP | $63.24 |
| Molina | Medicare Advantage | $65.56 |
| Molina | Medicare Choice Care HMO | $65.56 |
| Molina | Medicare Complete Care HMO SNP | $65.56 |
| Southwest Behavioral Health | Behavioral Health | $65.56 |
| UHC | Medicare Advantage | $65.56 |
| Donor Connect | Other | $355 |
| Aetna | Standard | $750 |
| BYU Athletics | Commercial | $750 |
| Campbell Scientific | Commercial | $750 |
| Cigna | HMO | $750 |
| Cigna | Open Access Flex | $750 |
| Cigna | PPO/EPO | $750 |
| Cigna | Utah Connect/Local Plus | $750 |
| Deseret Mutual | All Other | $750 |
| EMI Health | Mint | $750 |
| EMI Health | Network Care | $750 |
| EMI | Commercial | $750 |
| First Choice of the Midwest | Commercial | $750 |
| First Choice | Commercial | $750 |
| Franklin County | Commercial | $750 |
| Global Excel | Commercial | $750 |
| Health Utah | Commercial | $750 |
| Humana | Commercial | $750 |
| Hygeia Corporation | Commercial | $750 |
| Juniper Systems | Commercial | $750 |
Inpatient
$670cash price (self-pay)
$893list price
$321–$786range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $321 |
| American Health | Medicare Adv UT HMO I-SNP | $509 |
| Molina | Medicare Advantage | $536 |
| Molina | Medicare Choice Care HMO | $536 |
| Molina | Medicare Complete Care HMO SNP | $536 |
| AWH Connected | Connected Utah | $634 |
| Aetna | Connected | $634 |
| Aetna | Extended | $634 |
| Aetna | Standard | $634 |
| BYU Athletics | Commercial | $634 |
| Campbell Scientific | Commercial | $634 |
| Cigna | HMO | $634 |
| Cigna | Open Access Flex | $634 |
| Cigna | PPO/EPO | $634 |
| Cigna | Utah Connect/Local Plus | $634 |
| Deseret Mutual | All Other | $634 |
| EMI Health | Mint | $634 |
| EMI Health | Network Care | $634 |
| EMI | Commercial | $634 |
| First Choice of the Midwest | Commercial | $634 |
| First Choice | Commercial | $634 |
| Franklin County | Commercial | $634 |
| Global Excel | Commercial | $634 |
| Health Utah | Commercial | $634 |
| Humana | Commercial | $634 |
| Hygeia Corporation | Commercial | $634 |
| Juniper Systems | Commercial | $634 |
| LW Miller | Commercial | $634 |
| Managed Care Admin | Commercial | $634 |
| MedCare International | Commercial | $634 |
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All common services at Intermountain Health Primary Children's Hospital