CT head without contrast at Bellin Memorial Hospital. CPT 70450.
What Bellin Memorial Hospital publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$211cash price (self-pay)
$863list price
$52.32–$1,693range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Healthpartners | Select | $52.32 |
| AETNA | Medicare | $102 |
| ANTHEM | Managed Medicare | $102 |
| COMMUNITY CARE | Medicare Advantage | $102 |
| HUMANA | Medicare Advantage | $102 |
| ICARE | Managed Medicare | $102 |
| Managed Health Service | Medicare Advantage | $102 |
| My Choice | Medicare Advantage | $102 |
| Network Health | Medicare Advantage | $102 |
| Security Health Plan | Medicare Advantage | $102 |
| Healthpartners | Focus | $103 |
| Healthpartners | Broad | $112 |
| Chorus Community Health Plan | Managed Medicaid | $137 |
| Anthem | Managed Medicaid | $138 |
| COMMUNITY CARE | Managed Medicaid | $138 |
| ICARE | Managed Medicaid | $138 |
| Managed Health Service | Managed Medicaid | $138 |
| My Choice | SSI Managed Medicaid | $138 |
| Molina Health | Managed Medicaid | $142 |
| My Choice | BadgerChoice Plus Managed Medicaid | $145 |
| Anthem | Priority | $311 |
| Anthem | HMO/POS | $338 |
| United Health Care | HMO | $367 |
| Anthem | PPO | $409 |
| Chorus Community Health Plan | ALL PRODUCTS | $555 |
| Cigna Health and Life Insurance Company | ALL PRODUCTS | $602 |
| HPS/Paymedix | Medical Rental Network Tier 1 | $621 |
| WPS Insurance | BROAD | $647 |
| Security Health Plan | All Products | $656 |
| HPS/PayMedix | Medical Rental Network Tier 2 | $673 |
Inpatient
$211cash price (self-pay)
$863list price
$293–$1,143range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna Health and Life Insurance Company | ALL PRODUCTS | $609 |
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