RC 404
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
BRAIN IMAGING PET METABOL EVAL
Austin, TX
See all hospitals reporting RC 404 →Price type
Ascension Seton’s median price of $5.5k is 81% above the median hospital's median price ($3.0k), higher than 87% of the 1,496 hospitals reporting RC 404. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 12 payers, 80 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 4511_oscar health plan 20251001 per diem · outpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 2 | UnitedHealthcare 4501_united healthcare nexus city hmo (aus,nw,sw,bas) 20250701 case rate · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 3 | UnitedHealthcare 4503_united healthcare nexus city hmo (wil,hays) 20250701 case rate · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 4 | UnitedHealthcare 4504_united healthcare nexus city ppo (aus,nw,sw,bas) 20250401 case rate · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 5 | UnitedHealthcare 4506_united healthcare nexus city ppo (wil,hays) 20250701 case rate · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 6 | UnitedHealthcare 4507_united healthcare standard nexus aco (aus,nw,sw,bas) 20250701 case rate · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 7 | UnitedHealthcare 4509_united healthcare standard nexus aco (wil,hays) 20250701 case rate · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 8 | Blue Cross Blue Shield 4093_blue cross blue shield bav exchange (chi,dcn) 20250101 percent of total billed charges · outpatientfrom % of charges | $2.4k | $2.4k | $167 | 7% | — | $2.1k – $2.7k |
| 9 | Aetna 1377_aetna hmo exchange 20200101 case rate · outpatient | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 10 | UnitedHealthcare 4498_united healthcare (aus,nw,sw, bas) 20250701 per diem · outpatient | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 11 | UnitedHealthcare 4500_united healthcare (wil,hays) 20250701 per diem · outpatient | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 12 | Superior Healthplan 3509_chirp superior star (chi,dcn) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 13 | Superior Healthplan 3516_chirp superior star (sw) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 14 | Superior Healthplan 4375_chirp superior star plus (chi,dcn) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 15 | Superior Healthplan 4382_chirp superior star plus (sw) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 16 | Aetna 235_aetna pos 20140601 case rate · outpatient | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 17 | Aetna 236_aetna elect choice 20140601 case rate · outpatient | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 18 | Aetna 3438_aetna aco ppo 20240701 percent of total billed charges · outpatientfrom % of charges | $3.3k | $3.3k | $231 | 7% | — | $2.9k – $3.7k |
| 19 | Aetna 249_aetna ppo exchange 20140101 percent of total billed charges · outpatientfrom % of charges | $3.4k | $3.4k | $236 | 7% | — | $3.0k – $3.8k |
| 20 | Humana 387_humana exchange 20160101 percent of total billed charges · outpatientfrom % of charges | $3.9k | $3.9k | $270 | 7% | — | $3.4k – $4.3k |
| 21 | Aetna 4488_aetna ppo 20250801 percent of total billed charges · outpatientfrom % of charges | $3.9k | $4.0k | $275 | 7% | — | $3.5k – $4.4k |
| 22 | Humana 206_humana hmo custom 20140201 percent of total billed charges · outpatientfrom % of charges | $4.1k | $4.1k | $285 | 7% | — | $3.6k – $4.6k |
| 23 | Aetna 551_aetna hmo exchange (chi,dcn) 20170415 percent of total billed charges · outpatientfrom % of charges | $4.1k | $4.2k | $290 | 7% | — | $3.7k – $4.7k |
| 24 | Aetna 552_aetna ppo exchange (chi,dcn) 20170415 percent of total billed charges · outpatientfrom % of charges | $4.1k | $4.2k | $290 | 7% | — | $3.7k – $4.7k |
| 25 | UnitedHealthcare 3316_united healthcare standard nexus aco (chi,dcn) 20240101 percent of total billed charges · outpatientfrom % of charges | $4.4k | $4.5k | $310 | 7% | — | $3.9k – $5.0k |
Last updated: Jan 1, 2026
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