RC 174
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
NEWBORN - LEVEL IV
Low
$1.3k
Average
$4.5k
Median
$3.8k
High
$10.7k
Each hospital's average Medica rate, under the methodology and billing class chosen below.
50 hospitals; the 90th percentile is 5.1× 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.
Filter by billing methodology
Filter by billing class
66 hospital rates
iThe hospitals that file a Medica 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 | ALEGENT CREIGHTON HEALTH Papillion, NE per diem · inpatient | 3 | $3.3k | $3.1k | $403 | 13% | — | $2.6k – $3.5k |
| 2 | ALEGENT CREIGHTON HEALTH Omaha, NE per diem · inpatient | 3 | $3.3k | $3.1k | $403 | 13% | — | $2.6k – $3.5k |
| 3 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA per diem · inpatient | 3 | $3.3k | $3.7k | $566 | 15% | — | $3.3k – $4.5k |
| 4 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE per diem · inpatient | 3 | $3.3k | $3.7k | $566 | 15% | — | $3.3k – $4.5k |
| 5 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE per diem · inpatient | 3 | $3.3k | $3.4k | $429 | 13% | — | $2.9k – $3.9k |
| 6 | Ascension Via Christi Hospital Manhattan, Inc. Manhattan, KS other · both | 1 | $10.7k | $10.7k | — | — | — | $10.7k – $10.7k |
| 7 | Ascension Via Christi Hospital St. Teresa, Inc. Wichita, KS other · inpatient | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 8 | Ascension Via Christi Hospitals Wichita, Inc. Wichita, KS other · inpatient | 2 | $2.0k | $2.0k | $139 | 7% | — | $1.9k – $2.2k |
| 9 | Ascension Via Christi Rehabilitation Hospital, Inc. Wichita, KS other · inpatient | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 10 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE per diem · inpatient | 2 | $5.3k | $5.3k | $338 | 6% | — | $4.9k – $5.6k |
| 11 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · inpatientfrom % of charges | 1 | $2.2k | $2.2k | $235 | 11% | — | $1.8k – $2.4k |
| 12 | Banner Ogallala Community Hospital Ogallala, NE facility · per diem · inpatient | 1 | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
| 13 | Children's Mercy Hospital Kansas City, MO facility · percent of total billed charges · inpatientfrom % of charges | 1 | $9.0k | $9.0k | $296 | 3% | — | $8.7k – $9.3k |
| 14 | Children's Mercy Hospital Kansas City, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $9.0k | $9.0k | $296 | 3% | — | $8.7k – $9.3k |
| 15 | Children's Mercy Hospital Kansas Overland Park, KS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $9.0k | $9.0k | $296 | 3% | — | $8.7k – $9.3k |
| 16 | Children's Mercy Hospital Kansas Overland Park, KS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $9.0k | $9.0k | $296 | 3% | — | $8.7k – $9.3k |
| 17 | Curators of the University of Missouri Jefferson City, MO facility · per diem · inpatient | 1 | $7.2k | $7.2k | — | — | — | $7.2k – $7.2k |
| 18 | East Morgan County Hospital Brush, CO facility · per diem · inpatient | 1 | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 19 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · inpatientfrom % of charges | 7 | $9.7k | $8.9k | $2.0k | 22% | — | $5.4k – $11.3k |
| 20 | Fairview Health Services Minneapolis, MN per diem · inpatient | 6 | $10.1k | $8.8k | $3.3k | 37% | — | $1.5k – $11.0k |
| 21 | GOOD SAMARITAN HOSPITAL Kearney, NE fee schedule · inpatient | 1 | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 22 | GOOD SAMARITAN HOSPITAL Kearney, NE per diem · inpatient | 3 | $3.3k | $3.4k | $250 | 7% | — | $3.2k – $3.8k |
| 23 | Jane Phillips Memorial Medical Center Bartlesville, OK per diem · inpatient | 2 | $1.6k | $1.6k | $58 | 4% | — | $1.4k – $1.6k |
| 24 | Jane Phillips Memorial Medical Center Bartlesville, OK percent of total billed charges · bothfrom % of charges | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 25 | Jane Phillips Memorial Medical Center Bartlesville, OK percent of total billed charges · outpatientfrom % of charges | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
← Payers reporting RC 174 · Snapshot 20261111T120946Z-9134e7f7