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 Medical Mutual 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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106 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | AnMed Health Anderson, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1,336 | $2.84 – $3,400 |
| 2 | AnMed Health Cannon Pickens, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $14.25 | $14.25 – $14.25 |
| 3 | AnMed Piedmont Piedmont, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1,336 | $2.84 – $3,400 |
| 4 | Benefis Hospitals Inc Helena, MT fee schedule · outpatient | 1 | $13.08 | $0.22 – $41.70 |
| 5 | Benefis Hospitals Inc Helena, MT percent of total billed charges · bothfrom % of charges | 1 | $49.72 | $28.16 – $71.28 |
| 6 | Benefis Hospitals Inc Helena, MT percent of total billed charges · inpatientfrom % of charges | 1 | $108.37 | $12.02 – $620.90 |
| 7 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $86.52 | $4.08 – $239.69 |
| 8 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $72.75 | $4.08 – $233.98 |
| 9 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $230.02 | $86.30 – $435.27 |
| 10 | Columbus Regional Hospital Columbus, IN percent of total billed charges · bothfrom % of charges | 1 | $118.47 | $93.01 – $148.81 |
| 11 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $381.60 | $10.39 – $2,794 |
| 12 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $144.74 | $0.40 – $1,395 |
| 13 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $144.74 | $0.40 – $1,395 |
| 14 | Fairfield Medical Center 401 N Ewing St facility · percent of total billed charges · inpatientfrom % of charges | 2 | $198.05 | $103.05 – $381.23 |
| 15 | Fairfield Medical Center 401 N Ewing St facility · percent of total billed charges · outpatientfrom % of charges | 2 | $198.05 | $103.05 – $381.23 |
| 16 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $8.26 | $8.11 – $8.41 |
| 17 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $5.60 | $5.50 – $5.70 |
| 18 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 2 | $129.27 | $6.46 – $926.25 |
| 19 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 4 | $140.52 | $4.14 – $4,157 |
| 20 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 5 | $182.27 | $4.08 – $4,301 |
| 21 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 1 | $215.93 | $5.70 – $3,002 |
| 22 | Mayo Clinic Health System Lake City 55041-1143 facility · percent of total billed charges · bothfrom % of charges | 1 | $88.75 | $5.70 – $431.59 |
| 23 | Mayo Clinic Health System Saint James 56081-5550 facility · percent of total billed charges · bothfrom % of charges | 1 | $101.70 | $6.46 – $589.10 |
| 24 | Mayo Clinic Health System Fairmont 56031-4575 facility · percent of total billed charges · bothfrom % of charges | 1 | $122.21 | $5.70 – $926.25 |
| 25 | Mayo Clinic Health System Osseo, WI facility · percent of total billed charges · bothfrom % of charges | 3 | $179.09 | $5.83 – $3,065 |
← Payers reporting RC 255 · Snapshot 20261108T203506Z-bb90dbab