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 Excellus 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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31 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $282.66 | $12.25 – $997.44 |
| 2 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763.00 | $763.00 – $763.00 |
| 3 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $290.37 | $24.01 – $1,007 |
| 4 | Johnson Memorial Hospital Stafford Springs, CT facility · fee schedule · both | 1 | $98.91 | $50.51 – $168.35 |
| 5 | Margaretville Memorial Hospital Margaretville, NY facility · fee schedule · outpatient | 2 | $43.85 | $0.23 – $334.40 |
| 6 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $61.19 | $5.37 – $254.98 |
| 7 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $205.82 | $10.04 – $600.00 |
| 8 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $27.63 | $9.58 – $48.79 |
| 9 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $22.00 | $22.00 – $22.00 |
| 10 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · outpatient | 1 | $356.43 | $356.43 – $356.43 |
| 11 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $71.71 | $10.01 – $238.61 |
| 12 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · fee schedule · both | 1 | $59.92 | $15.30 – $102.00 |
| 13 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $31.74 | $14.07 – $41.78 |
| 14 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · fee schedule · both | 1 | $75.59 | $15.30 – $259.40 |
| 15 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $4,345 | $4,345 – $4,345 |
| 16 | Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges | 3 | $132.79 | $15.48 – $404.60 |
| 17 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · fee schedule · both | 1 | $23.13 | $3.41 – $66.49 |
| 18 | St Joseph Mercy Chelsea Chelsea, MI facility · fee schedule · both | 1 | $17.10 | $4.78 – $35.79 |
| 19 | St Joseph Mercy Livingston Hospital | Trinity Health Medical Center - Brighton Brighton, MI facility · fee schedule · both | 1 | $23.49 | $4.57 – $47.90 |
| 20 | St Joseph Mercy Livingston Hospital | Trinity Health Medical Center - Brighton Brighton, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $2,181 | $2,181 – $2,181 |
| 21 | St Joseph Mercy Oakland Pontiac, MI facility · fee schedule · both | 1 | $13.46 | $2.93 – $29.26 |
| 22 | St Joseph Mercy Oakland Pontiac, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $2,188 | $2,188 – $2,188 |
| 23 | St Josephs Hospital Health Center Syracuse, NY facility · fee schedule · both | 3 | $12.03 | $2.10 – $18.00 |
| 24 | St Mary Mercy Livonia Livonia, MI facility · fee schedule · both | 1 | $16.56 | $3.63 – $50.62 |
| 25 | St Mary Mercy Livonia Livonia, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1,882 | $1,882 – $1,882 |
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