RC 269
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.
Original text from hospital filings
TX/PROPH/DG ADDL SEQ IV INF
Low
$3
Average
$477
Median
$354
High
$2.4k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
116 hospitals; the 90th percentile is 9.4× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
137 hospital rates
iThe hospitals that file a UnitedHealthcare 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.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Eskenazi Health Indianapolis, IN facility · other · both | 3 | $76 | $76 | — | — | 48–66 | $76 – $76 |
| 2 | ATHOL MEMORIAL HOSPITAL INCORPORATED Athol, MA percent of total billed charges · outpatientfrom % of charges | 1 | $354 | $286 | $145 | 51% | 3–30 | $85 – $419 |
| 3 | AGH LAVEEN LLC Phoenix, AZ case rate · outpatient | 3 | $205 | $197 | $13 | 6% | — | $179 – $206 |
| 4 | AGH MESA LLC Mesa, AZ case rate · outpatient | 3 | $205 | $197 | $13 | 6% | — | $179 – $206 |
| 5 | Alexian Brothers Behavioral Health Hospital Estates, IL per diem · outpatient | 1 | $376 | $376 | — | — | — | $376 – $376 |
| 6 | Alexian Brothers Medical Center Village, IL per diem · outpatient | 1 | $376 | $376 | — | — | — | $376 – $376 |
| 7 | Ascension Calumet Hospital, Inc. Chilton, WI per diem · outpatient | 1 | $598 | $598 | — | — | — | $598 – $598 |
| 8 | Ascension Cedar Park Park, TX per diem · outpatient | 8 | $790 | $833 | $75 | 9% | — | $790 – $964 |
| 9 | Ascension NE Wisconsin, Inc. Appleton, WI per diem · outpatient | 1 | $598 | $598 | — | — | — | $598 – $598 |
| 10 | Ascension NE Wisconsin, Inc. Oshkosh, WI per diem · outpatient | 1 | $598 | $598 | — | — | — | $598 – $598 |
| 11 | Ascension SE Wisconsin Hospital, Inc. Milwaukee, WI per diem · outpatient | 1 | $577 | $577 | — | — | — | $577 – $577 |
| 12 | Ascension SE Wisconsin Hospital, Inc. Franklin, WI per diem · outpatient | 1 | $577 | $577 | — | — | — | $577 – $577 |
| 13 | Ascension SE Wisconsin Hospital, Inc. Brookfield, WI per diem · outpatient | 1 | $577 | $577 | — | — | — | $577 – $577 |
| 14 | Ascension Seton Austin, TX per diem · outpatient | 8 | $790 | $833 | $75 | 9% | — | $790 – $964 |
| 15 | Ascension Seton Austin, TX per diem · outpatient | 12 | $790 | $833 | $75 | 9% | — | $790 – $964 |
| 16 | Ascension Seton Austin, TX per diem · outpatient | 8 | $790 | $833 | $75 | 9% | — | $790 – $964 |
| 17 | Ascension Seton Luling, TX per diem · outpatient | 8 | $790 | $833 | $75 | 9% | — | $790 – $964 |
| 18 | Ascension Seton Burnet, TX per diem · inpatient | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 19 | Ascension Seton Burnet, TX per diem · outpatient | 8 | $790 | $833 | $75 | 9% | — | $790 – $964 |
| 20 | Ascension Seton Smithville, TX per diem · outpatient | 8 | $790 | $833 | $75 | 9% | — | $790 – $964 |
| 21 | Ascension Seton Bastrop, TX per diem · outpatient | 8 | $790 | $833 | $75 | 9% | — | $790 – $964 |
| 22 | Ascension Seton Austin, TX per diem · outpatient | 8 | $790 | $833 | $75 | 9% | — | $790 – $964 |
| 23 | Ascension St. Francis Hospital, Inc. Milwaukee, WI per diem · outpatient | 1 | $577 | $577 | — | — | — | $577 – $577 |
| 24 | Ascension Via Christi Hospital St. Teresa, Inc. Wichita, KS per diem · outpatient | 1 | $360 | $360 | — | — | — | $360 – $360 |
| 25 | Ascension Via Christi Hospitals Wichita, Inc. Wichita, KS per diem · outpatient | 1 | $360 | $360 | — | — | — | $360 – $360 |
← Payers reporting RC 269 · Snapshot 20261111T120946Z-9134e7f7