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
RH IG IM 300 MICRO GRAMS
Low
$21
Average
$100
Median
$72
High
$471
Each hospital's average Superior Healthplan rate, under the methodology and billing class chosen below.
35 hospitals; the 90th percentile is 7.0× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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35 hospital rates
iThe hospitals that file a Superior Healthplan 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.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Hendrick Medical Center Brownwood, TX facility · other · outpatient | 1 | $471 | $471 | — | — | 2–20 | $471 – $471 |
| 2 | Baylor Scott & White All Saints Medical Center - Fort Worth Fort Worth, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 3 | Baylor Scott & White Heart and Vascular Hospital - Dallas Dallas, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 4 | Baylor Scott & White Medical Center - Centennial Frisco, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 5 | Baylor Scott & White Medical Center - Frisco at PGA Parkway Frisco, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 6 | Baylor Scott & White Medical Center - Grapevine Grapevine, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 7 | Baylor Scott & White Medical Center - Irving Irving, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 8 | Baylor Scott & White Medical Center - Lake Pointe Rowlett, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 9 | Baylor Scott & White Medical Center - McKinney McKinney, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 10 | Baylor Scott & White Medical Center - Plano Plano, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 11 | Baylor Scott & White Medical Center at Waxahachie Waxahachie, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 12 | Baylor Scott & White The Heart Hospital - Denton Denton, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 13 | Baylor Scott & White The Heart Hospital - Plano Plano, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 14 | Baylor University Medical Center Dallas, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 15 | HCA HOUSTON HEALTHCARE CLEAR LAKE WEBSTER, TX percent of total billed charges · outpatientfrom % of charges | 5 | $53 | $53 | $1 | 2% | — | $51 – $54 |
| 16 | HCA HOUSTON HEALTHCARE CONROE CONROE, TX percent of total billed charges · outpatientfrom % of charges | 5 | $21 | $21 | — | — | — | $21 – $21 |
| 17 | HCA HOUSTON HEALTHCARE MEDICAL CENTER HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 5 | $83 | $83 | $57 | 69% | — | $26 – $140 |
| 18 | HCA HOUSTON HEALTHCARE NORTHWEST HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 5 | $135 | $135 | — | — | — | $135 – $135 |
| 19 | HCA HOUSTON HEALTHCARE TOMBALL Tomball, TX percent of total billed charges · outpatientfrom % of charges | 5 | $133 | $133 | — | — | — | $133 – $133 |
| 20 | HCA HOUSTON MAINLAND Texas City, TX percent of total billed charges · outpatientfrom % of charges | 5 | $48 | $48 | $3 | 7% | — | $45 – $51 |
| 21 | HCA Houston Healthcare North Cypress CYPRESS, TX percent of total billed charges · outpatientfrom % of charges | 5 | $87 | $87 | — | — | — | $87 – $87 |
| 22 | HEART HOSP OF AUSTIN Austin, TX percent of total billed charges · outpatientfrom % of charges | 7 | $91 | $184 | $108 | 59% | — | $91 – $309 |
| 23 | HEART HOSP OF AUSTIN AT ST. DAVID'S ROUND ROCK ROUND ROCK, TX percent of total billed charges · outpatientfrom % of charges | 7 | $91 | $184 | $108 | 59% | — | $91 – $309 |
| 24 | Longview Medical Center LP Longview, TX facility · fee schedule · outpatient | 2 | $91 | $91 | $51 | 56% | — | $40 – $142 |
| 25 | MEDICAL CITY ARLINGTON GRAND PRAIRIE, TX percent of total billed charges · outpatientfrom % of charges | 5 | $206 | $206 | — | — | — | $206 – $206 |
← Payers reporting HCPCS J2790 · Snapshot 20261111T120946Z-9134e7f7