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 Medicare 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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29 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL per diem · inpatient | 1 | $2,656 | $2,656 – $2,656 |
| 2 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $25.67 | $0.15 – $500.12 |
| 3 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $93.11 | $0.68 – $771.57 |
| 4 | Childrens Hospital of Los Angeles Angeles, CA facility · fee schedule · outpatient | 1 | $2,001 | $2,001 – $2,001 |
| 5 | Childrens Hospital of Los Angeles Angeles, CA professional · fee schedule · outpatient | 1 | $2.10 | $0.26 – $3.94 |
| 6 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $2,001 | $2,001 – $2,001 |
| 7 | East Morgan County Hospital Brush, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0.96 | $0.96 – $0.96 |
| 8 | Hackensack Meridian Mountainside Medical Center Montclair, NJ facility · percent of total billed charges · bothfrom % of charges | 1 | $174.72 | $2.37 – $3,152 |
| 9 | Margaretville Memorial Hospital Margaretville, NY facility · fee schedule · outpatient | 1 | $43.85 | $0.23 – $334.40 |
| 10 | Mercy Rehabilitation Hospital, LLC Smith, AR case rate · inpatient | 1 | $206.40 | $2.78 – $436.20 |
| 11 | Northside Hospital, Inc. Lawrenceville, GA fee schedule · outpatient | 1 | $1,254 | $1,254 – $1,254 |
| 12 | Northside Hospital, Inc. Atlanta, GA fee schedule · outpatient | 1 | $1,254 | $1,254 – $1,254 |
| 13 | Northside Hospital, Inc. Cumming, GA fee schedule · outpatient | 1 | $1,254 | $1,254 – $1,254 |
| 14 | Northside Hospital, Inc. Duluth, GA fee schedule · outpatient | 1 | $1,254 | $1,254 – $1,254 |
| 15 | Northside Hospital, Inc. Canton, GA fee schedule · outpatient | 1 | $1,254 | $1,254 – $1,254 |
| 16 | Penn Medicine Princeton Medical Center Princeton, NJ facility · fee schedule · outpatient | 1 | $24,228 | $24,228 – $24,228 |
| 17 | Pennsylvania Hospital of the University of Pennsylvania Health System Philadelphia, PA facility · fee schedule · outpatient | 1 | $24,228 | $24,228 – $24,228 |
| 18 | Pittsburg Hospital, LLC Pittsburg, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $88.09 | $11.70 – $433.78 |
| 19 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA facility · fee schedule · outpatient | 1 | $24,228 | $24,228 – $24,228 |
| 20 | Public Hospital District No 4 King County WA Snoqualmie, WA other · both | 1 | $49.21 | $1.27 – $115.91 |
| 21 | Quitman Hospital, LLC Quitman, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $47.43 | $6.15 – $107.41 |
| 22 | Sterling Regional Medical Center Sterling, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0.69 | $0.69 – $0.69 |
| 23 | The Methodist Hospitals, Inc. Gary, IN facility · fee schedule · outpatient | 1 | $0.01 | $0.01 – $0.01 |
| 24 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA facility · fee schedule · outpatient | 1 | $24,228 | $24,228 – $24,228 |
| 25 | ThedaCare Regional Medical Center-Berlin Inc WI 54971-9286; N2930 State Rd 22 Wautoma, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $84.88 | $3.91 – $189.84 |
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