CT head without contrast at Gundersen Moundview Hospital and Clinics. CPT 70450.
What Gundersen Moundview Hospital and Clinics publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$858cash price (self-pay)
$1,689list price
$144–$2,570range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid HMO | $144 |
| Alliance | Premier/All Products | $427 |
| Alliance | Comprehensive/All Products | $427 |
| Dean Health Plan | ASO | $557 |
| Quartz | All Products | $714 |
| Quartz | All Other Self Funded | $743 |
| Security Health Plan | Medicare Advantage | $777 |
| Anthem | Medicare HMO/PPO | $777 |
| Health Partners | Medicare Advantage | $777 |
| Quartz | Medicare Advantage | $777 |
| Security Health Plan | Medicare + Choice | $777 |
| UCARE | Dually Eligible | $777 |
| Quartz | Self Funded | $794 |
| UCARE | MSHO/Minnesota Special Needs | $811 |
| UCARE | Non-Dually Eligible | $811 |
| Quartz | Level Funded | $819 |
| Health Partners | Medicaid HMO | $845 |
| Anthem | Medicaid | $907 |
| Group Health Eau Claire | Medicaid HMO | $907 |
| Group Health of South Central | Medicaid HMO | $907 |
| Iowa Total Care | Medicaid | $907 |
| Managed Health Service | Managed Medicaid | $907 |
| Quartz | Medicaid_Badgercare | $907 |
| Quartz | Fully Insured | $921 |
| Health Partners | Medicare Cost | $1,013 |
| Cigna | All Products | $1,302 |
| Group Health of South Central | All Products | $1,351 |
| Trilogy | All Products | $1,351 |
| UCARE | Qualified Health Plan | $1,351 |
| Aspirus Arise Health | All Products | $1,402 |
Inpatient
$858cash price (self-pay)
$1,689list price
$714–$1,638range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $995 |
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All common services at Gundersen Moundview Hospital and Clinics