RC 255

Pharmacy

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

Regence rates for RC 255

The hospitals that file a Regence 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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60 hospital rates

#		Plans
1	ALBANY GENERAL HOSPITAL Albany, OR facility · percent of total billed charges · bothfrom % of charges	1	$309.04	$0.02 – $819.96
2	COMMONSPIRIT OREGON Pendleton, OR fee schedule · inpatient	1	$34.80	$29.60 – $40.00
3	COMMONSPIRIT OREGON Pendleton, OR fee schedule · outpatient	1	$34.80	$29.60 – $40.00
4	Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges	2	$189.23	$12.06 – $1,013
5	Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · inpatient	2	$0.78	$0.55 – $1.00
6	Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient	2	$0.78	$0.55 – $1.00
7	Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges	2	$372.33	$29.20 – $3,969
8	Cottage Grove Community Medical Ct Cottage Grove, OR facility · percent of total billed charges · inpatientfrom % of charges	2	$28.78	$0.46 – $200.54
9	ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient	1	$7.83	$6.29 – $9.36
10	GOOD SAMARITAN HOSPITAL CORVALLIS Corvallis, OR facility · percent of total billed charges · bothfrom % of charges	1	$309.04	$0.02 – $819.96
11	Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges	1	$282.66	$12.25 – $997.44
12	Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both	1	$763.00	$763.00 – $763.00
13	Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges	1	$290.37	$24.01 – $1,007
14	Johnson Memorial Hospital Stafford Springs, CT facility · fee schedule · both	1	$98.91	$50.51 – $168.35
15	MID COLUMBIA MEDICAL CENTER Dalles, OR other · outpatient	1	$2,594	$762.00 – $5,936
16	MID COLUMBIA MEDICAL CENTER Dalles, OR percent of total billed charges · outpatientfrom % of charges	4	$465.15	$149.14 – $1,162
17	MID-VALLEY HEALTHCARE INC Lebanon, OR facility · percent of total billed charges · bothfrom % of charges	1	$329.92	$0.02 – $875.38
18	MID-VALLEY HEALTHCARE INC Lebanon, OR facility · percent of total billed charges · outpatientfrom % of charges	1	$117.08	$0.01 – $310.65
19	Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both	1	$61.19	$5.37 – $254.98
20	Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges	1	$205.82	$10.04 – $600.00
21	Mercy Health Saint Marys Rockford, MI facility · fee schedule · both	1	$27.63	$9.58 – $48.79
22	Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both	1	$22.00	$22.00 – $22.00
23	Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · outpatient	1	$356.43	$356.43 – $356.43
24	NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK Tillamook, OR percent of total billed charges · outpatientfrom % of charges	3	$876.90	$564.58 – $1,045
25	Peace Harbor Medical Center Florence, OR facility · percent of total billed charges · inpatientfrom % of charges	2	$38.69	$1.50 – $375.26

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