RC 290
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
BUTTON, BALLOON MINIONE AMT 14FRX4.4CM
Low
$0
Average
$279
Median
$157
High
$3.2k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
60 hospitals; the 90th percentile is 8.5× 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.
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84 hospital rates
iThe hospitals that file a Molina 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $154 | $154 | $139 | 90% | — | $15 – $292 |
| 2 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $78 | $111 | $117 | 106% | — | $9 – $299 |
| 3 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $86 | $123 | $130 | 106% | — | $11 – $332 |
| 4 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $88 | $126 | $133 | 106% | — | $11 – $339 |
| 5 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $92 | $131 | $138 | 106% | — | $11 – $353 |
| 6 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · inpatientfrom % of charges | 2 | $75 | $75 | — | — | — | $75 – $75 |
| 7 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 2 | $75 | $75 | — | — | — | $75 – $75 |
| 8 | Carle Eureka Hospital Eureka, IL percent of total billed charges · inpatientfrom % of charges | 2 | $75 | $75 | — | — | — | $75 – $75 |
| 9 | Carle Eureka Hospital Eureka, IL percent of total billed charges · outpatientfrom % of charges | 2 | $128 | $128 | $53 | 41% | — | $75 – $180 |
| 10 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $78 | $112 | $118 | 106% | — | $10 – $301 |
| 11 | Deaconess Health System Henderson Hospital Henderson, KY professional · fee schedule · both | 4 | $0 | $282 | $364 | 129% | — | $0 – $752 |
| 12 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 3 | $0 | $251 | $355 | 141% | — | $0 – $752 |
| 13 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 3 | $0 | $160 | $276 | 173% | — | $0 – $639 |
| 14 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 3 | $0 | $192 | $293 | 153% | — | $0 – $639 |
| 15 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · fee schedule · both | 2 | $0 | $160 | $276 | 173% | — | $0 – $639 |
| 16 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · fee schedule · both | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · fee schedule · both | 2 | $0 | $161 | $279 | 173% | — | $0 – $645 |
| 18 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · inpatient | 1 | $3.0k | $3.0k | $2.7k | 92% | — | $233 – $5.7k |
| 19 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient | 3 | $1.9k | $2.4k | $2.4k | 101% | — | $141 – $6.6k |
| 20 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $83 | $118 | $125 | 106% | — | $10 – $318 |
| 21 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · both | 2 | $66 | $66 | $1 | 2% | — | $65 – $67 |
| 22 | Highland Hospital Rochester, NY fee schedule · outpatient | 2 | $139 | $149 | $133 | 89% | — | $3 – $527 |
| 23 | IHC Health Services Inc., DBA Intermountain Health Intermountain Medical Center Murray, UT facility · percent of total billed charges · inpatientfrom % of charges | 1 | $394 | $394 | — | — | — | $394 – $394 |
| 24 | IHC Health Services Inc., DBA Intermountain Health Intermountain Medical Center Murray, UT facility · percent of total billed charges · outpatientfrom % of charges | 1 | $394 | $394 | — | — | — | $394 – $394 |
| 25 | IHC Health Services Inc., DBA Intermountain Health LDS Hospital Salt Lake City, UT facility · percent of total billed charges · inpatientfrom % of charges | 1 | $394 | $394 | — | — | — | $394 – $394 |
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