Which payers have published criteria for CT neck soft tissue with contrast (CPT 70491)?

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 with contrast (CPT 70491)?

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 with contrast (CPT 70491)?

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 with contrast (CPT 70491) cost?

Across 1,089 hospitals that publish their negotiated rates, the median commercial insurance rate is $834, with the middle half of rates between $414 and $1,712. 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 with contrast (CPT 70491) 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 70491: CT neck soft tissue with contrast - Prior Authorization and Price

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CPT 70491

CT imaging of the neck is performed using contrast dye.

CT Head & Neck

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Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Neck Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Pediatric and Special Populations Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Neck Imaging Guidelines 1.0.2026, effective Feb 3, 2026	59 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	Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Neck Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Pediatric and Special Populations Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Neck Imaging Guidelines 1.0.2026, effective Feb 3, 2026	59 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	58 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 with contrast. Each has its own criteria for when the study is considered appropriate.

Melanomas and Other Skin Cancers Aetna · Cigna · UnitedHealthcare
Thyroid Cancer Aetna · Anthem BCBS · Cigna · UnitedHealthcare
Hodgkin Lymphoma Aetna · Cigna · UnitedHealthcare
Salivary Gland Cancers Aetna · Cigna · UnitedHealthcare
Squamous Cell Carcinomas of the Head and Neck Aetna · Cigna · UnitedHealthcare
Esophageal and GE Junction Cancer Aetna · Cigna · UnitedHealthcare
Metastatic Cancer, Carcinoma of Unknown Primary Site, and Other Types of Cancer Aetna · Cigna · UnitedHealthcare
Other Thoracic Tumors Aetna · Cigna · UnitedHealthcare
Non-Hodgkin Lymphomas Aetna · Cigna · UnitedHealthcare
Neck Pain/Neck Trauma Aetna · Cigna · UnitedHealthcare
Pediatric Lymphomas Aetna · Cigna · UnitedHealthcare
Thyroid and Parathyroid Aetna · Cigna · UnitedHealthcare
Brachial Plexus Aetna · Cigna · UnitedHealthcare
Cervical Lymphadenopathy Aetna · Cigna · UnitedHealthcare
Cranial Neuropathies Aetna · Cigna · UnitedHealthcare
Dysphagia and Upper Digestive Tract Disorders Aetna · Cigna · UnitedHealthcare
Dystonia/Torticollis Aetna · Cigna · UnitedHealthcare
Elevated Hemidiaphragm Aetna · Cigna · UnitedHealthcare
Esophagus Aetna · Cigna · UnitedHealthcare
Eye Disorders and Visual Loss Aetna · Cigna · UnitedHealthcare
Histiocytic Disorders Aetna · Cigna · UnitedHealthcare
Imaging of the Larynx, Trachea, and Bronchus Aetna · Cigna · UnitedHealthcare
Lymphadenopathy Aetna · Cigna · UnitedHealthcare
Neck Mass/Swelling/Adenopathy Aetna · Cigna · UnitedHealthcare
Neck Masses (Pediatric) Aetna · Cigna · UnitedHealthcare
Neuroblastoma Aetna · Cigna · UnitedHealthcare
Pediatric Leukemias Aetna · Cigna · UnitedHealthcare
Pediatric Nasopharyngeal Carcinoma Aetna · Cigna · UnitedHealthcare
Recurrent Laryngeal Nerve Palsy Aetna · Cigna · UnitedHealthcare
Salivary Gland Disorders Aetna · Cigna · UnitedHealthcare
Scalp and Skull Aetna · Cigna · UnitedHealthcare
Screening Imaging in Cancer Predisposition Syndromes Aetna · Cigna · UnitedHealthcare
Sore Throat, Odynophagia, and Hoarseness Aetna · Cigna · UnitedHealthcare
Trachea Aetna · Cigna · UnitedHealthcare
Trigeminal Neuralgia and other Centrally Mediated Facial Pain Syndromes Aetna · Cigna · UnitedHealthcare
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
Computed Tomography Medicare

Plus 34 more. Use the search below to find a specific condition.

Typical price

Commercial insurance, median

$834

Middle half of rates: $414 to $1,712

Medicare, hospital outpatient

$179

Facility payment

Medicare, physician fee schedule

$184

National, non-facility

Commercial figures come from negotiated rates published by 1,089 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 with contrast change.

CPT 70491: CT neck soft tissue with 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 70491: CT neck soft tissue with 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