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CT scan, head or brain, without contrast

2020 CPT/HCPCS 70450
Negotiated Private Fee $350.00
Prossam $260.00
Champva $116.84
First Medical $275.00
First Medical Vital $82.56
Plan de Salud Menonita $300.00
Menonita Vital $94.92
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $275.00
Mapfre $300.00
Mcs Classicare $210.00
MCS Life $225.00
Medicare Ambulatory Payment classification (APC)
MMM $122.02
MMM Vital $83.06
Panamerican Life $300.00
PMC $122.02
Tricare $113.79
Triple S Salud $275.00
Triple S Vital $115.50
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $82.56
Negotiated Maximus Charge $300.00
Discounted Cash Price $280.00

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