RC 255

Pharmacy at Allina Health Systems

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.

Generation details were not recorded for this description.

Original text from hospital filings

HCHG GASTROMARK ORAL PER 100ML

River Falls, WI

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Pricing by billing methodology

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How this price compares nationally

Allina Health Systems’s median price of $113 is 107% above the median hospital's median price ($54), higher than 69% of the 1,205 hospitals reporting RC 255. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting RC 255 at Allina Health Systems

Negotiated rates from the hospital’s own file: 6 payers, 21 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	Bcbs Mn bc pmap (r) facility · fee schedule · outpatient	$11.66	$11.66	$11.66 – $11.66
2	Bcbs Mn bc premier (r) facility · fee schedule · outpatient	$13.16	$13.16	$13.16 – $13.16
3	Blue Cross Blue Shield bc aehp (r) facility · fee schedule · outpatient	$15.48	$15.48	$15.48 – $15.48
4	Bcbs Mn bc state health plan (r) facility · fee schedule · outpatient	$17.49	$17.49	$17.49 – $17.49
5	Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges	$42.79	$49.49	$0.50 – $108.65
6	Medica medica pmap (r) facility · percent of total billed charges · outpatientfrom % of charges	$57.20	$66.17	$0.67 – $145.26
7	Bcbs Mn bc pmap (r) facility · percent of total billed charges · outpatientfrom % of charges	$74.83	$71.42	$0.69 – $148.82
8	Bcbs Mn bc premier (r) facility · percent of total billed charges · outpatientfrom % of charges	$89.57	$85.50	$0.82 – $178.15
9	Bcbs Mn bc state health plan (r) facility · percent of total billed charges · outpatientfrom % of charges	$94.67	$90.37	$0.87 – $188.30
10	Blue Cross Blue Shield bc aehp (r) facility · percent of total billed charges · outpatientfrom % of charges	$105.37	$100.58	$0.97 – $209.57
11	Blue Cross Blue Shield bc medicare (r) facility · fee schedule · outpatient	$94.47	$109.29	$1.11 – $239.90
12	Medica medica medicare (r) facility · fee schedule · outpatient	$94.47	$109.29	$1.11 – $239.90
13	Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges	$95.69	$110.70	$1.13 – $243.00
14	Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges	$130.29	$150.72	$1.53 – $330.86
15	Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges	$131.59	$152.22	$1.55 – $334.15
16	Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges	$140.76	$162.82	$1.65 – $357.43
17	Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges	$142.16	$164.44	$1.67 – $360.99
18	First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges	$178.63	$206.63	$2.10 – $453.60
19	First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges	$178.63	$206.63	$2.10 – $453.60
20	Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges	$179.86	$208.06	$2.11 – $456.73
21	Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges	$181.67	$210.15	$2.14 – $461.32

Last updated: Jun 15, 2026

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