Which payers have published criteria for CT chest without and with contrast (CPT 71270)?

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 chest without and with contrast (CPT 71270)?

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 chest without and with contrast (CPT 71270)?

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 chest without and with contrast (CPT 71270) cost?

Across 1,082 hospitals that publish their negotiated rates, the median commercial insurance rate is $986, with the middle half of rates between $492 and $2,090. A patient's own cost depends on their plan, deductible and where the study is done.

What can be done if CT chest without and with contrast (CPT 71270) 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 71270: CT chest without and with contrast - Prior Authorization and Price

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CPT 71270

Chest CT scan performed both without and with contrast dye.

CT Chest

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Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Chest Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Peripheral Nerve and Neuromuscular Disorders (PNND) Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Peripheral Vascular Disease (PVD) Imaging Guidelines 2.0.2026, effective Sep 1, 2026	14 that name this code
Anthem BCBS	Carelon	Oncologic imaging effective Apr 4, 2026 Imaging of the chest effective Apr 4, 2026 Advanced imaging for vascular indications effective Sep 19, 2026	91 that name this code
Cigna	eviCore	Chest Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Peripheral Nerve and Neuromuscular Disorders (PNND) Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Peripheral Vascular Disease (PVD) Imaging Guidelines 2.0.2026, effective Sep 1, 2026	14 that name this code
Medicare	CMS	NCD 220.1: Computed Tomography effective Mar 12, 2008 L33459: Computerized Axial Tomography (CT), Thorax (Palmetto GBA) effective Jun 11, 2026	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	13 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 chest without and with contrast. Each has its own criteria for when the study is considered appropriate.

Hemoptysis Aetna · Anthem BCBS · Cigna · UnitedHealthcare
Paraneoplastic syndrome Anthem BCBS
Acute Leukemia Anthem BCBS
Anal Cancer Anthem BCBS
Aortic dissection and other aortopathies Anthem BCBS
Bladder and Urothelial Cancers Anthem BCBS
Bladder/Urothelial Cancers: Muscle Invasive Anthem BCBS
Bladder/Urothelial Cancers: Non-muscle Invasive Anthem BCBS
Blunt or penetrating trauma to the thorax Anthem BCBS
Bone Sarcoma Anthem BCBS
Brain and Spinal Cord Malignancy Anthem BCBS
Breast Cancer Anthem BCBS
Bronchiectasis Anthem BCBS
Bronchiolitis obliterans Anthem BCBS
Bronchopleural fistula (Adult only) Anthem BCBS
Cancer screening, not otherwise specified Anthem BCBS
Cancers of the Pleura, Thymus, Heart, and Mediastinum Anthem BCBS
Cancers of Unknown Primary / Cancers Not Otherwise Specified Anthem BCBS
Cervical Cancer Anthem BCBS
Chest wall deformities including pectus excavatum (Pediatric only) Anthem BCBS
Chest wall mass Anthem BCBS
Chronic lymphocytic leukemia or small lymphocytic lymphoma Anthem BCBS
Colorectal Cancer Anthem BCBS
Colorectal cancer screening Anthem BCBS
Congenital or developmental vascular anomalies, not otherwise specified Anthem BCBS
Congenital pulmonary airway malformation (Pediatric only) Anthem BCBS
Congenital thoracic anomalies Anthem BCBS
Cough (chronic or persistent) Anthem BCBS
Diaphragmatic hernia Anthem BCBS
Dyspnea Anthem BCBS
Esophageal and Gastroesophageal Junction Cancers Anthem BCBS
Fever of unknown origin Anthem BCBS
Gastric Cancer Anthem BCBS
Gastrointestinal stromal tumor (GIST) Anthem BCBS
Head and Neck Cancer Anthem BCBS
Hepatocellular and Biliary Tract Cancers Anthem BCBS
Hepatocellular carcinoma (HCC) screening Anthem BCBS
Histiocytic Neoplasms Anthem BCBS
Hoarseness, dysphonia, and vocal cord weakness/paralysis – primary voice complaint Anthem BCBS
Horner’s syndrome Anthem BCBS

Plus 56 more. Use the search below to find a specific condition.

Typical price

Commercial insurance, median

$986

Middle half of rates: $492 to $2,090

Medicare, hospital outpatient

$179

Facility payment

Medicare, physician fee schedule

$197

National, non-facility

Commercial figures come from negotiated rates published by 1,082 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 chest without and with contrast change.

CPT 71270: CT chest without and 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 71270: CT chest without and 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