RC 254
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.
Generation details were not recorded for this description.
Original text from hospital filings
Isovue-370
Low
$2
Average
$232
Median
$144
High
$1.2k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
12 hospitals; the 90th percentile is 12.5× 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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15 hospital rates
iThe hospitals that file a Tricare 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 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 1 | $42 | $203 | $285 | 140% | 7–70 | $42 – $799 |
| 2 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 1 | $284 | $284 | $278 | 98% | 1–10 | $6 – $561 |
| 3 | Ascension Seton Smithville, TX percent of total billed charges · bothfrom % of charges | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 4 | Ascension Seton Smithville, TX percent of total billed charges · outpatientfrom % of charges | 2 | $73 | $73 | $56 | 77% | — | $17 – $129 |
| 5 | Ascension Seton Bastrop, TX percent of total billed charges · bothfrom % of charges | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 6 | Ascension Seton Bastrop, TX percent of total billed charges · outpatientfrom % of charges | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 7 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $247 | $247 | $91 | 37% | — | $155 – $338 |
| 8 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 9 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 10 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 11 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $289 | $289 | $289 | 100% | — | $0 – $579 |
| 12 | ROBERT PACKER HOSPITAL Doing Business As: ROBERT PACKER HOSPITAL, TOWANDA CAMPUS Towanda, PA facility · other · outpatient | 1 | $1.2k | $1.2k | $1.2k | 100% | — | $0 – $2.4k |
| 13 | TROY COMMUNITY HOSPITAL INCORPORATED Troy, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $43 | $43 | $43 | 100% | — | $0 – $86 |
| 14 | University of Virginia Haymarket Medical Center Haymarket, VA fee schedule · both | 1 | $144 | $144 | — | — | — | $144 – $144 |
| 15 | University of Virginia Prince William Medical Center Manassas, VA fee schedule · both | 1 | $144 | $144 | — | — | — | $144 – $144 |
← Payers reporting RC 254 · Snapshot 20261111T120946Z-9134e7f7