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
CIDOFOVIR/375MG 240MG/30ML SNIJ
Tucson, AZ
See all hospitals reporting RC 636 →Price type
Banner University Medical Center Tucson’s median price of $35 is 40% below the median hospital's median price ($59), higher than 32% 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: 8 payers, 32 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 medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $4.37 | $25.27 | $0.02 – $91.31 |
| 2 | Aetna qualified health plan facility · percent of total billed charges · outpatientfrom % of charges | $5.24 | $30.32 | $0.02 – $109.57 |
| 3 | Aetna banner employee plans facility · percent of total billed charges · outpatientfrom % of charges | $7.10 | $41.06 | $0.03 – $148.38 |
| 4 | Oscar commercial facility · percent of total billed charges · outpatientfrom % of charges | $10.91 | $63.16 | $0.05 – $228.27 |
| 5 | Aetna broad network facility · percent of total billed charges · inpatientfrom % of charges | $25.31 | $104.26 | $0.04 – $480.44 |
| 6 | Aetna designated group facility · percent of total billed charges · inpatientfrom % of charges | $25.31 | $104.26 | $0.04 – $480.44 |
| 7 | Aetna joint venture facility · percent of total billed charges · inpatientfrom % of charges | $25.31 | $104.26 | $0.04 – $480.44 |
| 8 | Aetna medical rental facility · percent of total billed charges · inpatientfrom % of charges | $31.53 | $129.89 | $0.05 – $598.57 |
| 9 | Aetna medical rental facility · percent of total billed charges · outpatientfrom % of charges | $31.53 | $129.89 | $0.05 – $598.57 |
| 10 | Aetna medicare advantage facility · fee schedule · outpatient | $276.00 | $276.00 | $22.62 – $529.38 |
| 11 | Bcbs Az medicare advantage facility · fee schedule · outpatient | $276.00 | $276.00 | $22.62 – $529.38 |
| 12 | Cigna hmo medicare advantage plans facility · fee schedule · outpatient | $276.00 | $276.00 | $22.62 – $529.38 |
| 13 | Cigna ppo medicare advantage plan facility · fee schedule · outpatient | $276.00 | $276.00 | $22.62 – $529.38 |
| 14 | Kaiser medicare advantage facility · fee schedule · outpatient | $276.00 | $276.00 | $22.62 – $529.38 |
| 15 | UnitedHealthcare uhc medicare advantage facility · fee schedule · outpatient | $276.00 | $276.00 | $22.62 – $529.38 |
| 16 | Humana medicare advantage facility · fee schedule · outpatient | $276.34 | $280.14 | $22.62 – $545.26 |
| 17 | Devoted medicare advantage facility · fee schedule · outpatient | $289.80 | $289.80 | $23.75 – $555.85 |
| 18 | Cigna commerical/hmo benefit plan/local flex plan/network benefit plan/open access plan facility · fee schedule · outpatient | $70.96 | $341.22 | $0.13 – $1,077 |
| 19 | Aetna broad network facility · fee schedule · outpatient | $87.86 | $352.72 | $0.22 – $1,282 |
| 20 | Aetna designated group facility · fee schedule · outpatient | $87.86 | $352.72 | $0.22 – $1,282 |
| 21 | Aetna joint venture facility · fee schedule · outpatient | $87.86 | $352.72 | $0.22 – $1,282 |
| 22 | Aetna qualified health plan facility · fee schedule · outpatient | $375.36 | $375.36 | $30.76 – $719.96 |
| 23 | UnitedHealthcare individual exchange facility · fee schedule · outpatient | $386.40 | $386.40 | $31.67 – $741.13 |
| 24 | Aetna banner employee plans facility · fee schedule · outpatient | $430.72 | $430.72 | $42.50 – $818.94 |
| 25 | Oscar commercial facility · fee schedule · outpatient | $455.40 | $455.40 | $37.32 – $873.48 |
Last updated: Mar 2, 2026
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