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
$97
Average
$1.2k
Median
$980
High
$7.2k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
89 hospitals; the 90th percentile is 3.8× 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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147 hospital rates
iThe 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.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Sanford USD Medical Center Sioux Falls, SD other · outpatient | 1 | $960 | $938 | $59 | 6% | 1,173–1,191 | $806 – $979 |
| 2 | Monument Health Network Inc Custer, SD percent of total billed charges · outpatientfrom % of charges | 2 | $543 | $828 | $817 | 99% | 208 | $32 – $3.0k |
| 3 | Monument Health Network Inc Sturgis, SD percent of total billed charges · outpatientfrom % of charges | 2 | $497 | $742 | $712 | 96% | 154–244 | $31 – $2.6k |
| 4 | Grundy County Memorial Hospital Grundy Center, IA facility · other · outpatient | 2 | $729 | $713 | $375 | 53% | 144–198 | $241 – $1.4k |
| 5 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · other · outpatient | 1 | $522 | $3.4k | $6.3k | 186% | 102 | $522 – $17.5k |
| 6 | Sanford Aberdeen Medical Center Aberdeen, SD other · outpatient | 1 | $920 | $920 | — | — | 77–104 | $920 – $920 |
| 7 | Pella Regional Health Center Pella, IA other · outpatient | 2 | $916 | $908 | $67 | 7% | 65–83 | $807 – $993 |
| 8 | Sanford Sheldon Medical Center Sheldon, IA other · outpatient | 2 | $993 | $964 | $58 | 6% | 52–106 | $902 – $1.1k |
| 9 | Sanford Vermillion Hospital Vermillion, SD percent of total billed charges · outpatientfrom % of charges | 2 | $1.0k | $1.4k | $774 | 57% | 17–26 | $371 – $2.7k |
| 10 | Sanford Webster Hospital Webster, SD percent of total billed charges · outpatientfrom % of charges | 2 | $952 | $1.2k | $659 | 53% | 16 | $390 – $2.3k |
| 11 | Mercy Health Services-Iowa Corp. Mason City, IA facility · other · both | 1 | $710 | $683 | $166 | 24% | 4–40 | $372 – $836 |
| 12 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 2 | $558 | $612 | $194 | 32% | 3–30 | $244 – $801 |
| 13 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · other · both | 1 | $749 | $639 | $139 | 22% | 3–30 | $334 – $749 |
| 14 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · outpatient | 3 | $558 | $3.4k | $6.7k | 197% | 2–20 | $8 – $18.7k |
| 15 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 2 | $558 | $632 | $170 | 27% | 2–20 | $244 – $801 |
| 16 | MercyOne Genesis DeWitt Medical Center DeWitt, IA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $673 | $677 | $431 | 64% | 2–20 | $151 – $1.2k |
| 17 | MercyOne Genesis DeWitt Medical Center DeWitt, IA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $657 | $661 | $447 | 68% | 2–20 | $119 – $1.4k |
| 18 | Morrison Community Hospital District Morrison, IL facility · fee schedule · both | 2 | $1.0k | $1.2k | $774 | 63% | 2–20 | $411 – $2.5k |
| 19 | Sanford Canton Inwood Medical Center Canton, SD percent of total billed charges · outpatientfrom % of charges | 2 | $1.0k | $1.3k | $657 | 50% | 2–20 | $443 – $2.3k |
| 20 | Sanford Chamberlain Medical Center Chamberlain, SD percent of total billed charges · outpatientfrom % of charges | 2 | $1.2k | $1.4k | $759 | 56% | 2–20 | $476 – $3.0k |
| 21 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · outpatient | 2 | $801 | $801 | — | — | 1–10 | $801 – $801 |
| 22 | Mishawaka Medical Center Mishawaka, IN facility · other · both | 1 | $2.0k | $2.0k | $653 | 32% | 1–10 | $891 – $2.9k |
| 23 | Mount Carmel Grove City Grove City, OH facility · other · both | 1 | $2.0k | $2.1k | $663 | 32% | 1–10 | $858 – $2.8k |
| 24 | Saint Marys Hospital Waterbury, CT facility · other · both | 1 | $1.9k | $1.9k | $624 | 32% | 1–10 | $848 – $2.8k |
| 25 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 2 | $1.2k | $1.3k | $790 | 63% | — | $76 – $2.5k |
← Payers reporting RC 483 · Snapshot 20261111T120946Z-9134e7f7