CT head without contrast at HSHS St. Mary's Hospital Medical Center. CPT 70450.
What HSHS St. Mary's Hospital Medical Center publishes for this service, straight from its standard-charges file, last updated March 24, 2026.
Outpatient / ER
$1,259cash price (self-pay)
$1,908list price
$102–$1,908range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Aetna Medicare | $102 |
| Anthem | Anthem Medicare Advantage HMO | $102 |
| Humana | Humana Medicare Advantage | $102 |
| Medicare Managed | Managed Medicare No Sequestration | $102 |
| Molina Healthcare | Molina Medicare | $102 |
| Anthem | Antehm Medicaid | $134 |
| Community Care Family Care | Community Care Family Care Medicaid Manag | $134 |
| Continuus Medicaid Managed | Continuus Medicaid Managed | $134 |
| Managed Health Services | Managed Health Services Medicaid | $134 |
| Meridian Health Plan | Meridian HMO Mcd | $134 |
| Molina Healthcare | Molina Medicaid | $142 |
| Naphcare | All Commerical Naphcare | $230 |
| Hshs Employees | Hshs Employees | $927 |
| Molina Healthcare Of Wi | All Commerical Molina Marketplace | $954 |
| P360 Small Group | Prevea 360 Small Group Commercial Plan | $1,215 |
| Prevea Health Network | Prevea Employees | $1,215 |
| Prevea Health Network | Prevea360 | $1,215 |
| Prevea Health Network | Prevea360 - Network | $1,215 |
| Anthem | Anthem POS/HMO | $1,239 |
| Anthem | Anthem PPO | $1,239 |
| Humana | Humana Choice Care HMO | $1,273 |
| Humana | Humana Natiional POS HMO | $1,273 |
| Cigna | All Commercial Cigna | $1,336 |
| Health Eos | All Commercial Health Eos | $1,355 |
| Healthsmart | All Commercial Healthsmart | $1,393 |
| Interplan | All Commercial Interplan Health Group | $1,393 |
| Network Health Plan | All Commerical Network Health Plan | $1,431 |
| Health Care Alliance | The Alliance | $1,603 |
| Multiplan/Phcs | All Commercial Multiplan | $1,603 |
| Choicecare | All Commercial Choice Care | $1,622 |
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All common services at HSHS St. Mary's Hospital Medical Center