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 Medicaid 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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48 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $1,179 | $1,179 – $1,179 |
| 2 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $2,291 | $2,291 – $2,291 |
| 3 | Allina Health Systems Ulm, MN facility · other · outpatient | 1 | $111.41 | $49.03 – $175.14 |
| 4 | Bullhead City Hospital Corporation City, AZ facility · other · outpatient | 2 | $1.55 | $0.19 – $3.81 |
| 5 | CentraState Medical Center Freehold Township, NJ percent of total billed charges · bothfrom % of charges | 1 | $19.10 | $0.26 – $80.84 |
| 6 | Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient | 2 | $11.08 | $0.15 – $30.00 |
| 7 | Childrens Hospital of Los Angeles Angeles, CA professional · fee schedule · outpatient | 2 | $6.48 | $0.45 – $25.65 |
| 8 | Chilton Medical Center Pompton Plains, NJ percent of total billed charges · bothfrom % of charges | 1 | $40.00 | $3.36 – $106.63 |
| 9 | GLENDALE ADVENTIST MEDICAL CENTER Glendale, CA fee schedule · outpatient | 1 | $3,603 | $840.00 – $6,366 |
| 10 | Geisinger Community Medical Center Scranton, PA fee schedule · outpatient | 1 | $1.00 | $1.00 – $1.00 |
| 11 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1.00 | $1.00 – $1.00 |
| 12 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1.00 | $1.00 – $1.00 |
| 13 | Granbury Hospital Corporation Granbury, TX facility · fee schedule · outpatient | 1 | $8.26 | $0.20 – $27.34 |
| 14 | HANFORD COMMUNITY HOSPITAL Selma, CA fee schedule · outpatient | 1 | $2,034 | $2,034 – $2,034 |
| 15 | Hackettstown Medical Center Hackettstown, NJ percent of total billed charges · bothfrom % of charges | 1 | $29.30 | $4.04 – $108.15 |
| 16 | Kirksville Missouri Hospital Co LLC PO Box C8502 Kirksville, MO facility · fee schedule · outpatient | 1 | $8.01 | $8.01 – $8.01 |
| 17 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $125.00 | $125.00 – $125.00 |
| 18 | Laredo Texas Hospital Company LP Laredo, TX facility · fee schedule · outpatient | 1 | $6.48 | $0.05 – $42.47 |
| 19 | Longview Medical Center LP Longview, TX facility · fee schedule · outpatient | 1 | $7.86 | $0.21 – $28.11 |
| 20 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $46.17 | $3.21 – $330.00 |
| 21 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $88.74 | $3.21 – $353.18 |
| 22 | McLeod Health Dillon, SC fee schedule · both | 1 | $0.58 | $0.30 – $35.69 |
| 23 | McLeod Health Cheraw, SC fee schedule · both | 1 | $0.57 | $0.30 – $35.69 |
| 24 | McLeod Health Manning, SC fee schedule · both | 1 | $0.58 | $0.30 – $35.69 |
| 25 | McLeod Health Florence, SC fee schedule · both | 1 | $0.58 | $0.30 – $35.69 |
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