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
citric acid-d gluconic acid 6.602-0.198 gram/100 m
Rapids, MN
See all hospitals reporting HCPCS Q2004 →Price type
Allina Health Systems’s median price of $79 is 25% below the median hospital's median price ($105), higher than 38% of the 975 hospitals reporting HCPCS Q2004. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 24 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 | UnitedHealthcare united healthcare (um) facility · case rate · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Medicaid medicaid ma (m) facility · fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 3 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $24 | $24 | — | — | — | $24 – $24 |
| 4 | Medica medica pmap (um) facility · percent of total billed charges · outpatientfrom % of charges | $26 | $26 | — | — | — | $26 – $26 |
| 5 | UnitedHealthcare uhc ubh pmap (m) facility · other · outpatient | $29 | $29 | — | — | — | $29 – $29 |
| 6 | Aetna aetna elevate (amu) facility · percent of total billed charges · outpatientfrom % of charges | $41 | $41 | — | — | — | $41 – $41 |
| 7 | Aetna aetna performance (amu) facility · percent of total billed charges · outpatientfrom % of charges | $44 | $44 | — | — | — | $44 – $44 |
| 8 | Medica medica dual solutions (m) facility · percent of total billed charges · outpatientfrom % of charges | $52 | $52 | — | — | — | $52 – $52 |
| 9 | Aetna aetna direct network (amu) facility · percent of total billed charges · outpatientfrom % of charges | $64 | $64 | — | — | — | $64 – $64 |
| 10 | Bcbs Mn bc aware/blue plus (a m u) facility · percent of total billed charges · outpatientfrom % of charges | $69 | $69 | — | — | — | $69 – $69 |
| 11 | Medica medica ubh (m) facility · percent of total billed charges · inpatientfrom % of charges | $82 | $82 | — | — | — | $82 – $82 |
| 12 | Medica medica elect (u m) facility · percent of total billed charges · outpatientfrom % of charges | $84 | $84 | — | — | — | $84 – $84 |
| 13 | Medica medica essentials (u m) facility · percent of total billed charges · outpatientfrom % of charges | $88 | $88 | — | — | — | $88 – $88 |
| 14 | Medica medica mhps (u m) facility · percent of total billed charges · outpatientfrom % of charges | $88 | $88 | — | — | — | $88 – $88 |
| 15 | Medica medica choice (u m) facility · percent of total billed charges · outpatientfrom % of charges | $93 | $93 | — | — | — | $93 – $93 |
| 16 | Medica medica ubh pmap (m) facility · percent of total billed charges · outpatientfrom % of charges | $94 | $94 | — | — | — | $94 – $94 |
| 17 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $99 | $99 | — | — | — | $99 – $99 |
| 18 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $99 | $99 | — | — | — | $99 – $99 |
| 19 | Medica medica ubh (m) facility · percent of total billed charges · outpatientfrom % of charges | $99 | $99 | — | — | — | $99 – $99 |
| 20 | Bcbs Mn bc pmap (amu) facility · other · outpatient | $110 | $110 | — | — | — | $110 – $110 |
| 21 | Bcbs Mn bc premier (m u) facility · other · outpatient | $124 | $124 | — | — | — | $124 – $124 |
| 22 | Blue Cross Blue Shield bc aehp (mu) facility · other · outpatient | $145 | $145 | — | — | — | $145 – $145 |
| 23 | Bcbs Mn bc state health plan (mu) facility · other · outpatient | $149 | $149 | — | — | — | $149 – $149 |
| 24 | Bcbs Mn bc high value/performance network (mu) facility · other · outpatient | $156 | $156 | — | — | — | $156 – $156 |
Last updated: Jun 17, 2026
See Renacidin irrigation solution for bladder stones, per 500 ml pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.