RC 636
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
levothyroxine (Synthroid) 100 mcg (0.1 mg) Injection
Tustin, CA
See all hospitals reporting RC 636 →Price type
Alta Newport Hospital, LLC’s median price of $47 is 21% below the median hospital's median price ($59), higher than 41% of the 1,987 hospitals reporting RC 636. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 33 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 | Aetna all gatekeeper plans facility · case rate · outpatient | $21.97 | $28.70 | $21.97 – $75.52 |
| 2 | Bcbs Ca covered california/ifp/ppo facility · fee schedule · outpatient | $2.42 | $39.49 | $0.01 – $5,073 |
| 3 | Bcbs Ca hmo facility · fee schedule · outpatient | $2.42 | $39.49 | $0.01 – $5,073 |
| 4 | Bcbs Ca epo/ppo/out of state facility · fee schedule · outpatient | $2.42 | $39.50 | $0.01 – $5,073 |
| 5 | Bcbs Ca covered california/ifp/ppo facility · percent of total billed charges · outpatientfrom % of charges | $32.83 | $41.18 | $0.09 – $431.27 |
| 6 | Bcbs Ca epo/ppo/out of state facility · percent of total billed charges · outpatientfrom % of charges | $32.83 | $41.18 | $0.09 – $431.27 |
| 7 | Bcbs Ca hmo facility · percent of total billed charges · outpatientfrom % of charges | $32.83 | $41.18 | $0.09 – $431.27 |
| 8 | Aetna exchange facility · percent of total billed charges · outpatientfrom % of charges | $46.63 | $68.81 | $0.14 – $1,204 |
| 9 | Anthem commercial hmo-ppo/covered california facility · percent of total billed charges · outpatientfrom % of charges | $76.62 | $112.34 | $0.22 – $1,950 |
| 10 | Aetna medicare advantage facility · case rate · outpatient | $8.54 | $120.62 | $0.01 – $5,168 |
| 11 | Anthem medicare advantage facility · case rate · outpatient | $8.54 | $120.62 | $0.01 – $5,168 |
| 12 | Bcbs Ca medicare advantage facility · case rate · outpatient | $8.54 | $120.62 | $0.01 – $5,168 |
| 13 | Humana medicare advantage facility · case rate · outpatient | $8.54 | $120.62 | $0.01 – $5,168 |
| 14 | Optum commercial hmo facility · case rate · outpatient | $8.54 | $120.62 | $0.01 – $5,168 |
| 15 | Optum medicare advantage facility · case rate · outpatient | $8.71 | $123.03 | $0.01 – $5,272 |
| 16 | WellCare medicare advantage facility · case rate · outpatient | $8.71 | $123.03 | $0.01 – $5,272 |
| 17 | UnitedHealthcare managed care facility · fee schedule · outpatient | $9.81 | $139.42 | $0.33 – $5,167 |
| 18 | Anthem ppg facility · percent of total billed charges · outpatientfrom % of charges | $95.78 | $141.07 | $0.28 – $2,437 |
| 19 | Aetna exchange facility · case rate · outpatient | $11.11 | $156.80 | $0.01 – $6,719 |
| 20 | Cigna hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $44.27 | $219.35 | $0.12 – $12,495 |
| 21 | Cigna hmo/ppo facility · percent of total billed charges · inpatientfrom % of charges | $44.27 | $219.63 | $0.12 – $12,495 |
| 22 | UnitedHealthcare managed care facility · percent of total billed charges · inpatientfrom % of charges | $47.70 | $236.65 | $0.13 – $13,463 |
| 23 | Aetna exchange facility · percent of total billed charges · inpatientfrom % of charges | $52.49 | $260.43 | $0.14 – $14,817 |
| 24 | Anthem commercial hmo-ppo/covered california facility · fee schedule · outpatient | $22.49 | $319.45 | $0.03 – $13,612 |
| 25 | Aetna all gatekeeper plans facility · percent of total billed charges · inpatientfrom % of charges | $68.54 | $340.04 | $0.18 – $19,346 |
Last updated: Mar 18, 2026
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