RC 636

Skin graft, 10 inch by 4 inch matrix at Advocate Good Samaritan Hospital

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

DEXAMETHASONE SOD PHOSPHATE PF 10 MG-ML IJ SOLN

Downers Grove, IL

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How this price compares nationally

Advocate Good Samaritan Hospital’s median price of $28 is 52% below the median hospital's median price ($59), higher than 25% of the 1,987 hospitals reporting RC 636. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting RC 636 at Advocate Good Samaritan Hospital

Negotiated rates from the hospital’s own file: 8 payers, 20 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Oscar medicare advantage other · outpatient	$10.40	$10.40	$10.40 – $10.40
2	Molina medicare advantage other · outpatient	$18.05	$18.05	$18.05 – $18.05
3	UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges	$32.16	$39.08	$18.83 – $100.80
4	Cigna commercial percent of total billed charges · outpatientfrom % of charges	$38.78	$56.37	$28.06 – $111.63
5	UnitedHealthcare hmo percent of total billed charges · outpatientfrom % of charges	$45.22	$59.96	$37.23 – $116.70
6	Blue Cross Blue Shield commercial percent of total billed charges · outpatientfrom % of charges	$42.07	$72.82	$0.60 – $1,078
7	Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges	$45.61	$79.64	$0.68 – $1,134
8	Cigna commercial fee schedule · outpatient	$4.48	$109.05	$0.02 – $4,147
9	UnitedHealthcare commercial fee schedule · outpatient	$3.94	$122.12	$0.02 – $6,983
10	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$34.83	$140.12	$0.42 – $4,845
11	Ambetter medicare advantage case rate · outpatient	$32.18	$164.44	$0.52 – $3,064
12	Molina medicare advantage case rate · outpatient	$32.18	$164.44	$0.52 – $3,064
13	Oscar medicare advantage case rate · outpatient	$33.29	$170.11	$0.54 – $3,170
14	UnitedHealthcare hmo fee schedule · outpatient	$6.27	$185.38	$0.03 – $6,983
15	Blue Cross Blue Shield managed care percent of total billed charges · outpatientfrom % of charges	$49.12	$193.98	$0.60 – $6,942
16	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$50.08	$197.75	$0.61 – $7,077
17	MultiPlan commercial percent of total billed charges · inpatientfrom % of charges	$50.84	$200.76	$0.62 – $7,185
18	MultiPlan commercial percent of total billed charges · outpatientfrom % of charges	$50.84	$200.76	$0.62 – $7,185
19	Blue Cross Blue Shield commercial fee schedule · outpatient	$172.15	$315.99	$0.08 – $4,238
20	Blue Cross Blue Shield ppo fee schedule · outpatient	$195.93	$345.58	$0.09 – $4,460

Last updated: Nov 4, 2025

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