Which payers have published criteria for CT neck soft tissue without contrast (CPT 70490)?

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 neck soft tissue without contrast (CPT 70490)?

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 neck soft tissue without contrast (CPT 70490)?

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 neck soft tissue without contrast (CPT 70490) cost?

Across 1,085 hospitals that publish their negotiated rates, the median commercial insurance rate is $675, with the middle half of rates between $318 and $1,407. A patient's own cost depends on their plan, deductible and where the study is done.

What can be done if CT neck soft tissue without contrast (CPT 70490) 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 70490: CT neck soft tissue without contrast - Prior Authorization and Price

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CPT 70490

Neck CT imaging performed without contrast dye.

CT Head & Neck

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Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Neck Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Peripheral Nerve and Neuromuscular Disorders (PNND) Imaging Guidelines 1.0.2026, effective Feb 3, 2026	12 that name this code
Anthem BCBS	Carelon	Imaging of the head and neck effective Apr 14, 2024 Oncologic imaging effective Apr 4, 2026	38 that name this code
Cigna	eviCore	Neck Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Peripheral Nerve and Neuromuscular Disorders (PNND) Imaging Guidelines 1.0.2026, effective Feb 3, 2026	12 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	12 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 neck soft tissue without contrast. Each has its own criteria for when the study is considered appropriate.

Acute Leukemia Anthem BCBS
Cancer screening, not otherwise specified Anthem BCBS
Cerebrospinal fluid (CSF) leak of the skull base Anthem BCBS
Colorectal cancer screening Anthem BCBS
Congenital and Developmental Conditions Anthem BCBS
Foreign body evaluation Anthem BCBS
Head and Neck Cancer Anthem BCBS
Histiocytic Neoplasms Anthem BCBS
Hoarseness, dysphonia, and vocal cord weakness/paralysis – primary voice complaint Anthem BCBS
Horner’s syndrome Anthem BCBS
Infectious conditions – not otherwise specified Anthem BCBS
Inflammatory conditions – not otherwise specified Anthem BCBS
Laryngeal edema Anthem BCBS
Localized facial pain (including trigeminal neuralgia) Anthem BCBS
Lymphoma – Hodgkin Anthem BCBS
Lymphoma – Non-Hodgkin Anthem BCBS
Melanoma Anthem BCBS
Merkel Cell Carcinoma Anthem BCBS
Neck mass (including lymphadenopathy) Anthem BCBS
Neuroendocrine Tumors Anthem BCBS
Osteonecrosis of the jaw Anthem BCBS
Paraneoplastic Syndrome Anthem BCBS
Parathyroid adenoma Anthem BCBS
Perioperative imaging, not otherwise specified Anthem BCBS
Recurrent epistaxis Anthem BCBS
Salivary gland ductal calculi Anthem BCBS
Sinusitis/rhinosinusitis Anthem BCBS
Stridor Anthem BCBS
Suspected or Known Metastases Anthem BCBS
Temporomandibular joint dysfunction Anthem BCBS
Thyroid Cancer Anthem BCBS
Thyroid nodule or thyromegaly (goiter) Anthem BCBS
Thyroid ophthalmopathy Anthem BCBS
Torticollis (Pediatric only) Anthem BCBS
Tracheal stenosis or upper airway obstruction Anthem BCBS
Trauma Anthem BCBS
Tumor – not otherwise specified Anthem BCBS
Visual disturbance or visual field defect Anthem BCBS
Neck Pain/Neck Trauma Aetna · Cigna · UnitedHealthcare
Salivary Gland Cancers Aetna · Cigna · UnitedHealthcare

Plus 7 more. Use the search below to find a specific condition.

Typical price

Commercial insurance, median

$675

Middle half of rates: $318 to $1,407

Medicare, hospital outpatient

$107

Facility payment

Medicare, physician fee schedule

$150

National, non-facility

Commercial figures come from negotiated rates published by 1,085 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 neck soft tissue without contrast change.

CPT 70490: CT neck soft tissue 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

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CPT 70490: CT neck soft tissue 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