RC 390
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
E7011 Aph Plt ACDA PASC LR <3 X log 11
Jervis, NY
See all hospitals reporting RC 390 →Price type
Bon Secours Community Hospital’s median price of $687 is 73% above the median hospital's median price ($397), higher than 82% of the 1,885 hospitals reporting RC 390. 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, 16 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 | Medicare medicare facility · fee schedule · outpatient | $138.16 | $217.23 | $53.17 – $949.13 |
| 2 | Molina affinity by molina mcr facility · fee schedule · outpatient | $144.35 | $226.97 | $55.56 – $991.70 |
| 3 | Tricare tricare facility · fee schedule · outpatient | $265.19 | $641.45 | $53.17 – $3,000 |
| 4 | Blue Cross Blue Shield blue cross access facility · percent of total billed charges · outpatientfrom % of charges | $690.10 | $923.81 | $134.00 – $2,613 |
| 5 | Blue Cross Blue Shield blue cross connection/exchange facility · percent of total billed charges · outpatientfrom % of charges | $690.10 | $923.81 | $134.00 – $2,613 |
| 6 | Blue Cross Blue Shield blue cross hmo facility · percent of total billed charges · outpatientfrom % of charges | $690.10 | $923.81 | $134.00 – $2,613 |
| 7 | Blue Cross Blue Shield blue cross small group facility · percent of total billed charges · outpatientfrom % of charges | $690.10 | $923.81 | $134.00 – $2,613 |
| 8 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $690.10 | $923.81 | $134.00 – $2,613 |
| 9 | UnitedHealthcare uhc commercial facility · percent of total billed charges · outpatientfrom % of charges | $690.10 | $923.81 | $134.00 – $2,613 |
| 10 | UnitedHealthcare uhc empire facility · percent of total billed charges · outpatientfrom % of charges | $690.10 | $923.81 | $134.00 – $2,613 |
| 11 | UnitedHealthcare uhc exchange facility · percent of total billed charges · outpatientfrom % of charges | $690.10 | $923.81 | $134.00 – $2,613 |
| 12 | Aetna aetna facility · percent of total billed charges · outpatientfrom % of charges | $721.00 | $965.18 | $140.00 – $2,730 |
| 13 | Aetna aetna employee facility · percent of total billed charges · outpatientfrom % of charges | $721.00 | $965.18 | $140.00 – $2,730 |
| 14 | Aetna aetna hp network facility · percent of total billed charges · outpatientfrom % of charges | $721.00 | $965.18 | $140.00 – $2,730 |
| 15 | Phcs phcs facility · percent of total billed charges · outpatientfrom % of charges | $721.00 | $965.18 | $140.00 – $2,730 |
| 16 | MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges | $772.50 | $1,034 | $150.00 – $2,925 |
Last updated: Jun 29, 2026
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