CT Scan of the Head Without Contrast
CPT 70450 is the most commonly ordered head CT scan, used for stroke evaluation, head trauma, and persistent headaches. Medicare pays $106.55 for this scan, but providers charge an average of $544.89 (a 5.1x markup). When done in the ER, the hospital facility fee adds $500 to $1,500 on top of the scan itself. Freestanding imaging centers offer this scan for $250 to $500 with no facility fee.
CPT 70450 at a Glance
- Average provider charge: $544.89
- Medicare rate: $106.55
- Typical markup: 5.1x over Medicare
- Freestanding center range: $250 to $500
- Setting: Same rate office and facility
- Common uses: Stroke, trauma, headache
- Outpatient beneficiaries: 192,718
- Components: Technical (TC) + Professional (26)
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How the Medicare Rate Is Calculated
Medicare prices every procedure using Relative Value Units (RVUs) across three components, then multiplies by a national conversion factor of $33.4009 (2026). For imaging codes like 70450, the non-facility and facility Practice Expense RVUs are identical, so Medicare pays the same rate regardless of setting. However, hospitals add their own facility fee on top, which is why hospital imaging costs more.
| Component | What It Covers | RVU |
|---|---|---|
| Work RVU | Radiologist time, skill, and judgment | 0.83 |
| Practice Expense RVU | CT equipment, technologist, supplies | 2.30 |
| Malpractice RVU | Professional liability insurance | 0.06 |
| Total RVU | 3.19 | |
| x $33.4009 | 2026 conversion factor | $106.55 |
Medicare Rate by State
Medicare adjusts the national rate using Geographic Practice Cost Indices (GPCIs). The same head CT pays differently depending on your location.
Medicare Rate by State (2026)
Medicare adjusts payments by location using Geographic Practice Cost Indices (GPCIs). Select your state to see the adjusted rate.
Sample State Rates
| State | Medicare Pays | Avg. Charge | Markup |
|---|---|---|---|
| Texas (Austin) | $110.83 | $544.89 | 4.9x |
| California (Los Angeles) | $121.07 | $544.89 | 4.5x |
| New York (Manhattan) | $121.94 | $544.89 | 4.5x |
| Florida (Fort Lauderdale) | $109.16 | $544.89 | 5.0x |
| Ohio | $99.88 | $544.89 | 5.5x |
| Mississippi | $95.35 | $544.89 | 5.7x |
| Arkansas | $94.75 | $544.89 | 5.8x |
| Alaska | $124.50 | $544.89 | 4.4x |
Rates shown use 2026 GPCIs and the $33.4009 conversion factor. For imaging codes, the Medicare physician fee is the same in office and facility settings. The average provider charge of $544.89 is the 2023 national average from CMS utilization data.
What Insured Patients Actually Pay for a Head CT
Your insurer has a negotiated rate with the imaging facility, typically 150% to 300% of the Medicare rate. For a head CT, that negotiated rate is usually $160 to $320. What you owe depends on your plan:
| Your Situation | What You Likely Pay | How It Works |
|---|---|---|
| Copay plan (deductible met) | $50 to $150 | Flat copay for imaging |
| Coinsurance plan (deductible met) | $32 to $64 | 20% of the negotiated rate ($160 to $320) |
| High-deductible plan (deductible NOT met) | $160 to $320 | Full negotiated rate until deductible is met |
| Medicare Part B | $21.31 | 20% of $106.55 after annual deductible |
Should You Use Insurance or Pay Cash?
If you have a high-deductible health plan and have not met your deductible, you are paying the full negotiated rate for imaging. For a head CT, this is typically $160 to $320 through insurance. Freestanding imaging centers often offer cash-pay rates of $250 to $500 for this scan, and some offer prices as low as $200.
When Cash-Pay Wins
- The freestanding center's cash rate is close to or below your insurer's negotiated rate
- You are unlikely to meet your deductible this year
- You need the scan quickly and the cash-pay center has shorter wait times
- Your insurance requires prior authorization that is delaying the scan
When Using Insurance Wins
- You are close to meeting your annual deductible
- Your plan has a low imaging copay (some plans offer $50 to $100 flat copays)
- You expect more medical expenses later this year
- The scan needs to be documented in your insurance records for follow-up care
Common Billing Problems with Head CT Scans
Separate bills for technical and professional components
You may receive two bills for one head CT: one from the facility (technical component, modifier -TC) and one from the radiologist (professional component, modifier -26). This is normal for hospital-based imaging but can be confusing. Together, these two bills should roughly equal the global rate. If the combined total significantly exceeds the global rate, question the charges.
ER facility fees that dwarf the scan cost
When a head CT is done in the emergency room, the ER facility fee ($500 to $1,500) often exceeds the cost of the scan itself. If your condition was not a true emergency and your doctor ordered the CT for evaluation of chronic headaches or non-urgent symptoms, getting the scan at a freestanding imaging center on an outpatient basis could save you $1,000 or more.
Wrong code: 70450 vs 70460
CPT 70450 is the non-contrast head CT. CPT 70460 is the head CT with contrast, which costs more. Verify that the code on your bill matches the scan you actually received. If you did not receive contrast material (an IV injection during the scan), you should be billed under 70450, not 70460.
Missing prior authorization
Most insurance plans require prior authorization for CT scans. If your provider did not obtain authorization before the scan, your insurer may deny the claim and leave you with the full bill. ER scans are generally exempt from prior authorization requirements. If your outpatient CT claim was denied for lack of authorization, ask your provider to submit a retroactive authorization request.
Related Imaging Codes
| Code | Description | Medicare Rate |
|---|---|---|
| 70450 | CT head without contrast | $106.55 |
| 70460 | CT head with contrast | Higher |
| 70553 | MRI brain with and without contrast | $316.97 |
Frequently Asked Questions
How much does a CT scan of the head cost without insurance?
Without insurance, a head CT (CPT 70450) costs $250 to $600 depending on location and facility type. The national average provider charge is $544.89. Freestanding imaging centers typically charge $250 to $500, while hospital outpatient departments charge significantly more. Medicare pays $106.55 for this scan.
Why is my head CT bill so much higher than the Medicare rate?
The average provider charge for CPT 70450 is $544.89, which is 5.1 times the Medicare rate. Hospital-based imaging adds a separate facility fee on top. If your CT was done in an ER, the facility fee alone can add $500 to $1,500. Freestanding imaging centers are typically 50 to 70% cheaper because they do not charge facility fees.
What is the difference between CPT 70450 and 70460?
CPT 70450 is a CT of the head without contrast. CPT 70460 is a CT of the head with contrast. The contrast version costs more because it includes the contrast material and additional imaging sequences. For stroke or trauma evaluation, the non-contrast version (70450) is typically ordered first.
Does insurance cover a head CT scan?
Most insurance plans cover head CT scans when medically necessary, but many require prior authorization. If you have a high-deductible plan and have not met your deductible, you will pay the full negotiated rate. Medicare Part B covers 80% after your deductible is met, leaving you with about $21 in coinsurance. For HDHP patients, comparing cash-pay at a freestanding center versus the insurer's negotiated rate is worth doing.
Need Help Lowering a Medical Bill?
CareRoute Bill Defense is a done-for-you bill reduction service. We analyze the codes on your imaging bill, identify overcharges and coding errors, and apply reduction strategies on your behalf. If your head CT bill seems too high, we can help.
Learn about Bill Defense