RC 352
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
CT scan of arm before and after contrast
The hospitals that file a Wellmark 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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158 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 2 | $2,320 | $129.00 – $5,471 |
| 2 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · inpatient | 2 | $2,204 | $122.55 – $5,197 |
| 3 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $187.42 | $82.81 – $335.86 |
| 4 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · inpatientfrom % of charges | 1 | $4,367 | $2,345 – $8,036 |
| 5 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $4,367 | $2,345 – $8,036 |
| 6 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 2 | $195.98 | $88.91 – $356.43 |
| 7 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · outpatient | 3 | $311.97 | $93.13 – $438.90 |
| 8 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · other · both | 1 | $173.66 | $83.20 – $333.53 |
| 9 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · other · outpatient | 1 | $222.97 | $167.69 – $333.53 |
| 10 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · both | 2 | $196.73 | $106.81 – $356.43 |
| 11 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · outpatient | 2 | $211.49 | $179.20 – $243.77 |
| 12 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · other · both | 1 | $180.35 | $99.95 – $333.53 |
| 13 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · other · outpatient | 1 | $197.90 | $167.69 – $228.11 |
| 14 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $1,535 | $778.74 – $3,331 |
| 15 | Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient | 1 | $188.13 | $83.82 – $339.99 |
| 16 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 2 | $195.09 | $88.91 – $356.43 |
| 17 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient | 2 | $242.75 | $106.81 – $438.90 |
| 18 | Covenant Medical Center Inc Waterloo, IA facility · other · both | 1 | $180.51 | $82.81 – $331.97 |
| 19 | Covenant Medical Center Inc Waterloo, IA facility · other · outpatient | 1 | $198.24 | $99.48 – $331.97 |
| 20 | Diley Ridge Medical Center Canal Winchester, OH facility · other · both | 1 | $651.39 | $313.01 – $1,255 |
| 21 | Diley Ridge Medical Center Canal Winchester, OH facility · other · outpatient | 1 | $914.63 | $630.88 – $1,255 |
| 22 | Grinnell Regional Medical Center Grinnell, IA case rate · outpatient | 1 | $178.00 | $83.82 – $339.99 |
| 23 | Grundy County Memorial Hospital Grundy Center, IA facility · other · outpatient | 2 | $619.59 | $156.50 – $916.89 |
| 24 | Grundy County Memorial Hospital Grundy Center, IA facility · percent of total billed charges · inpatientfrom % of charges | 2 | $1,215 | $238.55 – $2,454 |
| 25 | HAWARDEN REGIONAL HEALTHCARE HARWARDEN, IA other · both | 2 | $1,059 | $383.92 – $2,001 |
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