RC 483
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
HC Tte F-Up or Lmtd - Tte Limited W/ Contrast
Low
$1
Average
$692
Median
$536
High
$19.9k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
588 hospitals; the 90th percentile is 4.3× 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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894 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 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $657 | $912 | $788 | 86% | 1,866–1,983 | $109 – $2.6k |
| 2 | St. Joseph Medical Center Bellingham, WA facility · other · outpatient | 2 | $318 | $755 | $1.9k | 256% | 728–818 | $4 – $11.2k |
| 3 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $532 | $533 | $233 | 44% | 711–765 | $44 – $1.1k |
| 4 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 1 | $387 | $388 | $169 | 44% | 487–586 | $32 – $830 |
| 5 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 7 | $711 | $1.3k | $1.1k | 86% | 471–480 | $245 – $3.5k |
| 6 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 2 | $422 | $663 | $578 | 87% | 354–363 | $44 – $2.1k |
| 7 | SVMC HOLDINGS INC D/B/A ST VINCENT�S MEDICAL CENTER BRIDGEPORT, CT case rate · outpatient | 2 | $2.1k | $2.1k | $82 | 4% | 224 | $2.0k – $2.2k |
| 8 | BAPTIST HEALTHCARE SYSTEM INC Lexington, KY percent of total billed charges · outpatientfrom % of charges | 1 | $436 | $436 | $190 | 44% | 218–353 | $36 – $933 |
| 9 | SVMC HOLDINGS INC D/B/A ST VINCENT�S MEDICAL CENTER BRIDGEPORT, CT other · outpatient | 1 | $200 | $1.6k | $3.7k | 224% | 205–223 | $10 – $10.7k |
| 10 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS fee schedule · outpatient | 2 | $675 | $675 | $244 | 36% | 203–212 | $430 – $919 |
| 11 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC per diem · both | 1 | $430 | $430 | — | — | 173–227 | $430 – $430 |
| 12 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC per diem · both | 1 | $430 | $430 | — | — | 173–227 | $430 – $430 |
| 13 | THE WILLIAM W BACKUS HOSPITAL PLAINFIELD, CT other · outpatient | 1 | $160 | $1.9k | $3.9k | 208% | 173–182 | $10 – $10.7k |
| 14 | THE CHARLOTTE HUNGERFORD HOSPITAL TORRINGTON, CT other · outpatient | 1 | $98 | $130 | $82 | 63% | 149–167 | $10 – $223 |
| 15 | PeaceHealth Southwest Medical Center Vancouver, WA facility · other · outpatient | 3 | $242 | $264 | $252 | 95% | 148–238 | $1 – $930 |
| 16 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY percent of total billed charges · outpatientfrom % of charges | 1 | $436 | $436 | $190 | 44% | 114–186 | $36 – $933 |
| 17 | METHODIST LEBONHEUR CHILDRENS HOSP TN 38301; 7691 POPLAR AVE. MEMPHIS, TN fee schedule · both | 2 | $409 | $403 | $116 | 29% | 114–258 | $182 – $511 |
| 18 | BAPTIST HEALTHCARE SYSTEM INC Richmond, KY percent of total billed charges · outpatientfrom % of charges | 1 | $436 | $436 | $190 | 44% | 110–218 | $36 – $933 |
| 19 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · other · both | 1 | $521 | $509 | $158 | 31% | 104–140 | $227 – $747 |
| 20 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · other · outpatient | 1 | $521 | $4.0k | $6.8k | 171% | 101–110 | $521 – $17.5k |
| 21 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY percent of total billed charges · outpatientfrom % of charges | 1 | $387 | $388 | $169 | 44% | 92–173 | $32 – $830 |
| 22 | HARTFORD HOSPITAL HARTFORD, CT other · outpatient | 1 | $200 | $1.6k | $3.7k | 224% | 87 | $10 – $10.7k |
| 23 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC per diem · both | 1 | $428 | $428 | — | — | 85–157 | $428 – $428 |
| 24 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC per diem · both | 1 | $428 | $428 | — | — | 85–157 | $428 – $428 |
| 25 | Methodist Hospitals of Dallas Dallas, TX percent of total billed charges · bothfrom % of charges | 1 | $1.7k | $1.3k | $720 | 56% | 73–100 | $227 – $2.1k |
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