Which payers have published criteria for CT head without contrast (CPT 70450)?

The imaging guidelines used by Aetna, Anthem BCBS, Cigna, Medicare, UnitedHealthcare include criteria that apply to this study. Whether a specific patient's plan requires prior authorization depends on the plan, so confirm on the payer's portal or by phone before scheduling.

Who reviews prior authorization requests for CT head without contrast (CPT 70450)?

Most commercial payers hand imaging reviews to a radiology benefit manager. For the payers tracked here, requests are reviewed using guidelines from eviCore, Carelon, CMS, UnitedHealthcare / eviCore. The request is submitted through that organization's portal rather than the health plan's general line.

What should be in the clinical notes before requesting CT head without contrast (CPT 70450)?

Reviewers look for a recent office visit that documents the symptoms and how long they have lasted, exam findings, results of any earlier imaging, treatments already tried and how the patient responded, and the specific question the study is expected to answer. The diagnosis code on the request should match what the notes describe.

How much does CT head without contrast (CPT 70450) cost?

Across 1,092 hospitals that publish their negotiated rates, the median commercial insurance rate is $639, with the middle half of rates between $304 and $1,287. A patient's own cost depends on their plan, deductible and where the study is done.

What can be done if CT head without contrast (CPT 70450) is denied?

Read the denial letter for the stated reason, then request a peer-to-peer conversation between the ordering clinician and the reviewing physician, which often resolves missing-information denials. If that fails, file a written appeal that answers the stated reason directly and attach the supporting notes. The denial letter lists the deadline and where to send the appeal.

CPT 70450: CT head without contrast - Prior Authorization and Price

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CPT 70450

CT imaging of the head or brain done without any contrast dye.

CT Head & Neck

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Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric and Special Populations Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric and Special Populations Spine Imaging Guidelines 1.0.2026, effective Feb 3, 2026	68 that name this code
Anthem BCBS	Carelon	Oncologic imaging effective Apr 4, 2026 Advanced imaging for vascular indications effective Sep 19, 2026 Imaging of the head and neck effective Apr 14, 2024 Imaging of the brain effective Sep 19, 2026	14 that name this code
Cigna	eviCore	Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric and Special Populations Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric and Special Populations Spine Imaging Guidelines 1.0.2026, effective Feb 3, 2026	69 that name this code
Medicare	CMS	NCD 220.1: Computed Tomography effective Mar 12, 2008 L37373: MRI and CT Scans of the Head and Neck (Noridian Healthcare Solutions) effective Oct 23, 2025	2 that name this code
Original Medicare does not run a prior authorization program for outpatient imaging; claims are judged against the coverage policies above. Medicare Advantage plans set their own prior authorization rules.
UnitedHealthcare	UnitedHealthcare / eviCore	Commercial and Exchange Cardiovascular and Radiology Imaging Guidelines 09.2026, effective Sep 1, 2026	68 that name this code

Guidelines collected from the payers' published documents on September 29, 2026. Payers revise these documents during the year. Open the guideline link to confirm the current version before you submit.

Conditions the guidelines address for this study

These are the clinical situations where payer guidelines discuss CT head without contrast. Each has its own criteria for when the study is considered appropriate.

Headache Aetna · Cigna · UnitedHealthcare
CNS and Head Infection/Neuro-COVID-19 Aetna · Cigna · UnitedHealthcare
Chiari and Skull-Base Malformations Aetna · Cigna · UnitedHealthcare
Mild Cognitive Impairment (MCI) and Dementia Aetna · Cigna · UnitedHealthcare
Ataxia Aetna · Cigna · UnitedHealthcare
Cerebrovascular Disease Aetna · Cigna · UnitedHealthcare
Dizziness, Vertigo and Syncope Aetna · Cigna · UnitedHealthcare
Head and Facial Trauma Aetna · Cigna · UnitedHealthcare
Mental Health Disorders and Mental Status Change Aetna · Cigna · UnitedHealthcare
Neurosurgical Imaging Aetna · Cigna · UnitedHealthcare
Cerebral Aneurysm and AVM Aetna · Cigna · UnitedHealthcare
Epilepsy/Seizures Aetna · Cigna · UnitedHealthcare
Eye Disorders and Visual Loss Aetna · Cigna · UnitedHealthcare
Movement Disorders Aetna · Cigna · UnitedHealthcare
Other Imaging Studies Aetna · Cigna · UnitedHealthcare
Papilledema/Pseudotumor Cerebri Aetna · Cigna · UnitedHealthcare
Pituitary, Sella, Hypothalamus Aetna · Cigna · UnitedHealthcare
Scalp and Skull Aetna · Cigna · UnitedHealthcare
CNS Tumors Aetna · Cigna · UnitedHealthcare
Epilepsy and Other Seizure Disorders Aetna · Cigna · UnitedHealthcare
Intracranial Aneurysms and AVM Aetna · Cigna · UnitedHealthcare
Macrocephaly, Microcephaly, and Hydrocephalus Aetna · Cigna · UnitedHealthcare
Pediatric Head and Face Trauma Aetna · Cigna · UnitedHealthcare
Pediatric Leukemias Aetna · Cigna · UnitedHealthcare
Suspected Physical Child Abuse Aetna · Cigna · UnitedHealthcare
Behavioral and Psychiatric Disorders Aetna · Cigna · UnitedHealthcare
CNS Infection Aetna · Cigna · UnitedHealthcare
Craniofacial Anomalies Aetna · Cigna · UnitedHealthcare
Hematopoietic Stem Cell Transplantation (HSCT) Aetna · Cigna · UnitedHealthcare
Other Congenital and Pediatric Spine Disorders Aetna · Cigna · UnitedHealthcare
Pediatric Headache Aetna · Cigna · UnitedHealthcare
Pediatric Stroke Aetna · Cigna · UnitedHealthcare
Spinal Dysraphism and Tethered Spinal Cord Aetna · Cigna · UnitedHealthcare
Brain and Spinal Cord Malignancy Anthem BCBS
Cancer screening, not otherwise specified Anthem BCBS
Cerebral perfusion imaging Anthem BCBS
Cerebrospinal fluid (CSF) leak of the skull base Anthem BCBS
Colorectal cancer screening Anthem BCBS
Computed Tomography Medicare
Congenital or developmental vascular anomalies, not otherwise specified Anthem BCBS

Plus 9 more. Use the search below to find a specific condition.

Typical price

Commercial insurance, median

$639

Middle half of rates: $304 to $1,287

Medicare, hospital outpatient

$107

Facility payment

Medicare, physician fee schedule

$107

National, non-facility

Commercial figures come from negotiated rates published by 1,092 hospitals; Medicare figures from CMS fee schedules. Rates vary widely by hospital and plan. Pricing data from CenterIQ.

Get notified when the rules for this study change

Payers update imaging guidelines several times a year. We will email you when the criteria for CT head without contrast change.

CPT 70450: CT head without contrast - Prior Authorization and Price

Payer guidelines that apply

Conditions the guidelines address for this study

Typical price

Get notified when the rules for this study change

Frequently asked questions

Imaging CPT Code Coverage Lookup

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CPT 70450: CT head without contrast - Prior Authorization and Price

Payer guidelines that apply

Conditions the guidelines address for this study

Typical price

Get notified when the rules for this study change

Frequently asked questions

Related studies

Imaging CPT Code Coverage Lookup

Quick Access - Common Imaging CPT Codes

CT

MRI

MRA

PET