CT head without contrast at Froedtert Holy Family Memorial Hospital. CPT 70450.
What Froedtert Holy Family Memorial Hospital publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$1,020cash price (self-pay)
$1,854list price
$101–$1,632range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Cross Blue Shield | Medicare Advantage | $101 |
| Community Care Incorporated | Medicare Advantage | $101 |
| Health Partners | Medicare Advantage | $101 |
| Humana | Medicare Advantage | $101 |
| ICare | Medicare Advantage | $101 |
| Molina | Medicare Advantage | $101 |
| Network Health Plan | Medicare Advantage | $101 |
| Security Health Plan | Medicare Advantage | $101 |
| United Healthcare | Medicare Advantage | $101 |
| Allwell | Medicare Advantage | $103 |
| Molina | Marketplace Plans | $109 |
| Medical College of Wisconsin | Employee Plan | $612 |
| Centivo | WI 2 Median | $742 |
| Anthem Blue Cross Blue Shield (Healthlink) | HMO/PPO | $794 |
| Centivo | WI 1 Broad | $853 |
| Dean Health Plan | All Plans | $927 |
| Network Health Plan | ACA | $930 |
| Network Health Plan | HMO | $1,033 |
| United Healthcare | Manitowoc Schools | $1,045 |
| United Healthcare | Nexus | $1,112 |
| Sheboygan Employers Health Network | All Contracted Commercial Plans | $1,112 |
| Health Payment Systems | All Contracted Commercial Plans | $1,175 |
| Chorus Community Health Plan | Marketplace Plans | $1,192 |
| Health Partners | All Contracted Commercial Plans | $1,205 |
| Trilogy | All Contracted Commercial Plans | $1,224 |
| United Healthcare Choice/Navigate | APA | $1,306 |
| Cigna | All Contracted Commercial Plans | $1,335 |
| WPS Health Plan | All Contracted Commercial Plans | $1,372 |
| Aspirus | Marketplace Plans | $1,483 |
| HealthEos | All Contracted Commercial Plans | $1,483 |
Inpatient
$1,020cash price (self-pay)
$1,854list price
$1,112–$1,632range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Sheboygan Employers Health Network | All Contracted Commercial Plans | $1,112 |
| Trilogy | All Contracted Commercial Plans | $1,224 |
| Cigna | All Contracted Commercial Plans | $1,335 |
| Aspirus | Marketplace Plans | $1,483 |
| HealthEos | All Contracted Commercial Plans | $1,483 |
| Multiplan/Private Healthcare Systems | All Contracted Commercial Plans | $1,483 |
| Preferred One | All Contracted Commercial Plans | $1,483 |
| Security Health Plan | All Contracted Commercial Plans | $1,483 |
| HealthSmart | All Contracted Commercial Plans | $1,539 |
| First Health Network | All Contracted Commercial Plans | $1,632 |
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All common services at Froedtert Holy Family Memorial Hospital