RC 250
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
ampicillin-sulbactam 3 gram Solr 1 each VIAL
Ulm, MN
See all hospitals reporting RC 250 →Price type
Allina Health Systems’s median price of $9 is 50% below the median hospital's median price ($18), higher than 32% of the 1,901 hospitals reporting RC 250. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 30 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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Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Bcbs Mn bc pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $1.76 | $15.74 | $0.83 – $3,643 |
| 2 | Bcbs Mn bc premier(n) facility · percent of total billed charges · outpatientfrom % of charges | $2.10 | $18.84 | $0.99 – $4,361 |
| 3 | Bcbs Mn bc state health plan (n) facility · percent of total billed charges · outpatientfrom % of charges | $2.22 | $19.92 | $1.05 – $4,610 |
| 4 | Blue Cross Blue Shield bc aehp (n) facility · percent of total billed charges · outpatientfrom % of charges | $2.47 | $22.17 | $1.16 – $5,130 |
| 5 | Bcbs Mn bc high value/performance network (n) facility · percent of total billed charges · outpatientfrom % of charges | $2.65 | $23.79 | $1.25 – $5,507 |
| 6 | Bcbs Mn bc pmap (n) facility · other · outpatient | $0.92 | $27.60 | $0.01 – $5,058 |
| 7 | Bcbs Mn bc premier(n) facility · other · outpatient | $1.04 | $31.15 | $0.01 – $5,708 |
| 8 | Blue Cross Blue Shield bc aehp (n) facility · other · outpatient | $1.21 | $36.65 | $0.01 – $6,715 |
| 9 | Bcbs Mn bc high value/performance network (n) facility · other · outpatient | $1.30 | $39.34 | $0.01 – $7,208 |
| 10 | Bcbs Mn bc state health plan (n) facility · other · outpatient | $1.37 | $41.40 | $0.02 – $7,587 |
| 11 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $5.69 | $86.89 | $0.60 – $18,942 |
| 12 | Aetna allina aetna medicare (n) facility · fee schedule · outpatient | $28.31 | $117.98 | $0.24 – $4,909 |
| 13 | Medicare medicare (n) facility · fee schedule · outpatient | $29.80 | $124.19 | $0.25 – $5,167 |
| 14 | Medica medica pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $8.99 | $137.33 | $0.95 – $29,938 |
| 15 | Medicaid medicaid ma (n) facility · other · outpatient | $12.37 | $189.04 | $1.31 – $41,211 |
| 16 | Medica medica medicare (r) facility · fee schedule · outpatient | $12.56 | $191.86 | $1.33 – $41,826 |
| 17 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $12.71 | $194.33 | $1.35 – $42,365 |
| 18 | Blue Cross Blue Shield bc medicare (n) facility · fee schedule · outpatient | $13.14 | $200.79 | $1.40 – $43,772 |
| 19 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $17.28 | $264.73 | $1.84 – $57,682 |
| 20 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $17.48 | $267.23 | $1.86 – $58,257 |
| 21 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $18.67 | $285.98 | $1.99 – $62,314 |
| 22 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $18.88 | $288.69 | $2.01 – $62,936 |
| 23 | Cigna hpi cigna (n) facility · other · outpatient | $19.74 | $292.40 | $0.15 – $64,940 |
| 24 | Medica medica ubh (n) facility · percent of total billed charges · inpatientfrom % of charges | $19.74 | $302.45 | $2.10 – $65,901 |
| 25 | Medica medica ubh pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $22.60 | $345.48 | $2.40 – $75,316 |
Last updated: Jun 16, 2026
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