RC 490
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
SKIN SUB GRFT T/ARM/LG CHILD
Kyle, TX
See all hospitals reporting RC 490 →Price type
Ascension Seton’s median price of $5.9k is 149% above the median hospital's median price ($2.4k), higher than 82% of the 792 hospitals reporting RC 490. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 13 payers, 101 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 | Blue Cross Blue Shield 3597_blue cross chip/star kids (hay) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $526 | $526 | — | — | — | $526 – $526 |
| 2 | Blue Cross Blue Shield 3696_chirp blue cross star (hay) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $526 | $526 | — | — | — | $526 – $526 |
| 3 | UnitedHealthcare 3740_chirp uhc star (hay) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $526 | $526 | — | — | — | $526 – $526 |
| 4 | UnitedHealthcare 3751_chirp uhc star plus (hay) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $526 | $526 | — | — | — | $526 – $526 |
| 5 | UnitedHealthcare 4325_uhc star kids (hay) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $526 | $526 | — | — | — | $526 – $526 |
| 6 | Humana 206_humana hmo custom 20140201 other · outpatient | $969 | $969 | — | — | — | $969 – $969 |
| 7 | Ambetter 3879_superior ambetter (chi,dcn) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 8 | Ambetter 3880_superior ambetter (chi,dcn) outpatient 20240901 percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 9 | Blue Cross Blue Shield 3594_blue cross chip/star kids (chi,dcn) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 10 | Blue Cross Blue Shield 3693_chirp blue cross star (chi,dcn) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 11 | UnitedHealthcare 3737_chirp uhc star (chi,dcn) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 12 | UnitedHealthcare 3748_chirp uhc star plus (chi,dcn) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 13 | UnitedHealthcare 4322_uhc star kids (chi,dcn) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 14 | Blue Cross Blue Shield 4219_chirp blue cross star (chi,dcn) outpatient 20241201 percent of total billed charges · bothfrom % of charges | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 15 | Blue Cross Blue Shield 4093_blue cross blue shield bav exchange (chi,dcn) 20250101 percent of total billed charges · outpatientfrom % of charges | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 16 | Superior Healthplan 3509_chirp superior star (chi,dcn) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 17 | Superior Healthplan 3512_chirp superior star (hay) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 18 | Superior Healthplan 4188_superior star foster outpatient 20241201 percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 19 | Superior Healthplan 4189_superior star foster (chi,dcn) outpatient 20241201 percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 20 | Superior Healthplan 4241_chirp superior star (chi,dcn) outpatient 20241201 percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 21 | Superior Healthplan 4244_chirp superior star (hay) outpatient 20241201 percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 22 | Superior Healthplan 4375_chirp superior star plus (chi,dcn) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 23 | Superior Healthplan 4378_chirp superior star plus (hay) inpatient 20240901 percent of total billed charges · bothfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 24 | Superior Healthplan 4389_chirp superior star plus (chi,dcn) outpatient 20241201 percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 25 | Superior Healthplan 4395_chirp superior star plus (hay) outpatient 20241201 percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
Last updated: Jan 1, 2026
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