RC 622

Medical supplies used during diagnostic services

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

WIRE DOC 22260 ACS

Payers reporting RC 622

Payer pricing summary

Low

$14

Average

$851

Median

$729

High

$4.2k

Payer rate distribution

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#
1	Anthem fee schedule · both · +5 other terms	17	$29	$29	—	—	—	$29 – $29
2	Aetna fee schedule · outpatient · +8 other terms	12	$14	$14	—	—	—	$14 – $14
3	Cigna fee schedule · outpatient · +6 other terms	12	$14	$14	—	—	—	$14 – $14
4	MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +5 other terms	12	$14	$243	$881	363%	—	$4 – $4.3k
5	UnitedHealthcare fee schedule · outpatient · +10 other terms	12	$14	$15	$2	14%	—	$14 – $18
6	Blue Cross Blue Shield fee schedule · outpatient · +7 other terms	9	$452	$452	$1.1k	239%	—	$15 – $13.4k
7	Ambetter fee schedule · outpatient · +2 other terms	6	$22	$22	—	—	—	$22 – $22
8	Caresource fee schedule · outpatient · +2 other terms	6	$20	$20	—	—	—	$20 – $20
9	First Health percent of total billed charges · bothfrom % of charges · +2 other terms	6	$3.4k	$2.2k	$2.9k	129%	—	$13 – $6.2k
10	Humana fee schedule · outpatient · +3 other terms	6	$14	$14	$0	1%	—	$14 – $14
11	WellCare fee schedule · outpatient	6	$14	$14	—	—	—	$14 – $14
12	Bcbs Tx facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	3	$335	$335	—	—	—	$335 – $335
13	Medicaid percent of total billed charges · bothfrom % of charges	2	$22	$22	$14	66%	—	$6 – $48
14	Optum percent of total billed charges · bothfrom % of charges · +1 other terms	2	$33	$33	$16	48%	—	$17 – $48
15	Aetna Better Health percent of total billed charges · bothfrom % of charges · +2 other terms	1	$161	$161	—	—	—	$161 – $161
16	Bcbs Tn facility · fee schedule · outpatient	1	$988	$988	$2.4k	241%	—	$33 – $29.5k
17	Devoted facility · other · outpatient · +1 other terms	1	$35	$35	—	—	—	$35 – $35
18	Highmark facility · other · outpatient · +2 other terms	1	$63	$63	$16	26%	—	$43 – $89
19	Kaiser facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	1	$4.2k	$4.2k	—	—	—	$4.2k – $4.2k
20	Magellan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	1	$88	$88	—	—	—	$88 – $88
21	Medical Mutual facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	1	$40	$40	$26	66%	—	$3 – $79
22	Molina fee schedule · outpatient · +6 other terms	1	$77	$77	$3	4%	—	$74 – $80
23	Oscar facility · other · outpatient · +1 other terms	1	$43	$43	—	—	—	$43 – $43
24	Phcs percent of total billed charges · inpatientfrom % of charges · +1 other terms	1	$812	$812	—	—	—	$812 – $812
25	Superior Healthplan facility · percent of total billed charges · bothfrom % of charges	1	$23	$23	$14	59%	—	$10 – $37

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