Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC CT PELVIS W/CONTRAST
The hospitals that file a Premera rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.
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81 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · inpatient | 1 | $1,623 | $1,623 – $1,623 |
| 2 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · outpatient | 1 | $1,727 | $1,727 – $1,727 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 1 | $179.20 | $179.20 – $179.20 |
| 4 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · both | 1 | $179.20 | $179.20 – $179.20 |
| 5 | Central Washington Health Services Association Wenatchee, WA other · outpatient | 1 | $345.68 | $345.68 – $345.68 |
| 6 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · outpatientfrom % of charges | 3 | $1,368 | $1,270 – $1,394 |
| 7 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · inpatient | 1 | $2,325 | $2,325 – $2,325 |
| 8 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient | 1 | $2,325 | $2,325 – $2,325 |
| 9 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $3,249 | $3,249 – $3,249 |
| 10 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $179.20 | $179.20 – $179.20 |
| 11 | Diley Ridge Medical Center Canal Winchester, OH facility · other · both | 1 | $630.88 | $630.88 – $630.88 |
| 12 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA case rate · outpatient | 1 | $777.58 | $777.58 – $777.58 |
| 13 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient | 1 | $1,051 | $1,051 – $1,051 |
| 14 | FRANCISCAN HEALTH SYSTEM Gig Harbor, WA case rate · outpatient | 3 | $415.99 | $207.82 – $614.84 |
| 15 | FRANCISCAN HEALTH SYSTEM Tacoma, WA case rate · outpatient | 3 | $415.99 | $207.82 – $614.84 |
| 16 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 4 | $634.80 | $337.83 – $843.63 |
| 17 | HARRISON MEDICAL CENTER Silverdale, WA case rate · outpatient | 3 | $577.51 | $213.69 – $797.31 |
| 18 | HIGHLINE MEDICAL CENTER Burien, WA case rate · outpatient | 3 | $417.88 | $204.08 – $557.13 |
| 19 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $314.64 | $314.64 – $314.64 |
| 20 | Holy Cross Germantown Hospital Germantown, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $120.00 | $120.00 – $120.00 |
| 21 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $1,839 | $1,839 – $1,839 |
| 22 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $293.03 | $293.03 – $293.03 |
| 23 | Holy Cross Hospital-Silver Spring Silver Spring, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $120.00 | $120.00 – $120.00 |
| 24 | Johnson Memorial Hospital Stafford Springs, CT facility · fee schedule · both | 1 | $794.00 | $794.00 – $794.00 |
| 25 | Mary Bridge Children's Hospital Tacoma, WA fee schedule · outpatient | 4 | $634.80 | $337.83 – $843.63 |
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