RC 255
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
GADOBUTROL 1 MMOL/ML IV SOLN
The hospitals that file a Carefirst 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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52 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Children's National Hospital Washington, DC facility · fee schedule · inpatient | 2 | $5.15 | $0.19 – $24.09 |
| 2 | Children's National Hospital Washington, DC facility · fee schedule · outpatient | 2 | $8.10 | $0.30 – $37.85 |
| 3 | Children's National Hospital Washington, DC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $8.80 | $0.31 – $73.32 |
| 4 | Children's National Hospital Washington, DC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $7.72 | $0.26 – $115.95 |
| 5 | Children's National Rehabilitation and Specialized Care Washington, DC facility · percent of total billed charges · inpatientfrom % of charges | 2 | $14.53 | $0.49 – $126.18 |
| 6 | Children's National Rehabilitation and Specialized Care Washington, DC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $14.53 | $0.49 – $126.18 |
| 7 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $277.66 | $11.54 – $1,008 |
| 8 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763.00 | $763.00 – $763.00 |
| 9 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $284.84 | $22.52 – $1,017 |
| 10 | Johnson Memorial Hospital Stafford Springs, CT facility · fee schedule · both | 1 | $98.91 | $50.51 – $168.35 |
| 11 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 3 | $799.31 | $799.31 – $799.31 |
| 12 | MedStar Georgetown Hospital Washington, DC facility · fee schedule · outpatient | 3 | $41.78 | $0.20 – $1,254 |
| 13 | MedStar Georgetown Hospital Washington, DC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1,479 | $1,479 – $1,479 |
| 14 | MedStar Good Samaritan Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 3 | $1,955 | $1,955 – $1,955 |
| 15 | MedStar Harbor Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 3 | $1,778 | $1,778 – $1,778 |
| 16 | MedStar Montgomery Medical Center Olney, MD percent of total billed charges · outpatientfrom % of charges | 3 | $961.21 | $961.21 – $961.21 |
| 17 | MedStar Southern Hospital Center Clinton, MD percent of total billed charges · outpatientfrom % of charges | 3 | $1,408 | $1,408 – $1,408 |
| 18 | MedStar St. Mary's Hospital Leonardtown, MD percent of total billed charges · outpatientfrom % of charges | 3 | $838.42 | $838.42 – $838.42 |
| 19 | MedStar Union Memorial Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 3 | $1,524 | $1,524 – $1,524 |
| 20 | MedStar Washington Hospital Center NW, WA facility · fee schedule · outpatient | 3 | $40.23 | $0.24 – $1,254 |
| 21 | MedStar Washington Hospital Center NW, WA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1,229 | $1,229 – $1,229 |
| 22 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $61.19 | $5.37 – $254.98 |
| 23 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $205.82 | $10.04 – $600.00 |
| 24 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $27.63 | $9.58 – $48.79 |
| 25 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $22.00 | $22.00 – $22.00 |
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