CT head without contrast at Ascension SE Wisconsin Hospital - Franklin Campus. CPT 70450.
What Ascension SE Wisconsin Hospital - Franklin Campus publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$842cash price (self-pay)
$1,588list price
$103–$1,239range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare Replacement | 1205_medicare Replacement Outpatient 20250101 | $103 |
| Veterans Administration | 1208_veteran Administration Outpatient 20250 | $103 |
| Smart Health | 1206_smarthealth Outpatient 20250101 | $145 |
| Wps | 1272_wisconsin Physician Services PPO 20250701 | $240 |
| United Health Care | 1282_united Health Care 20250701 | $245 |
| Trilogy | 1271_trilogy 20250701 | $724 |
| Cigna | 1273_cigna 20250701 | $1,239 |
Inpatient
—cash price (self-pay)
—list price
$103–$145range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare Replacement | 1321_medicare Replacement Inpatient 20251001 | $103 |
| Veterans Administration | 1323_veteran Administration Inpatient 202510 | $103 |
| Smart Health | 1317_smarthealth Inpatient 20251001 | $145 |
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All common services at Ascension SE Wisconsin Hospital - Franklin Campus