RC 255
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.
Generation details were not recorded for this description.
Original text from hospital filings
IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION
Clovis, CA
See all hospitals reporting RC 255 →Price type
Clovis Community Medical Center’s median price of $78 is 43% above the median hospital's median price ($54), higher than 57% of the 1,205 hospitals reporting RC 255. 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, 19 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 hmoppo facility · fee schedule · outpatient | $0.16 | $0.71 | $0.08 – $16.01 |
| 2 | Blue Cross Blue Shield managed medi-cal facility · fee schedule · outpatient | $0.17 | $0.83 | $0.08 – $14.75 |
| 3 | Molina managed medi-cal facility · fee schedule · outpatient | $0.17 | $0.83 | $0.08 – $14.75 |
| 4 | Aetna medicare hmo for chp facility · fee schedule · outpatient | $134.24 | $207.08 | $56.12 – $1,033 |
| 5 | Aetna medicare hmo for non-chp facility · fee schedule · outpatient | $134.24 | $207.08 | $56.12 – $1,033 |
| 6 | Aetna ppo facility · fee schedule · outpatient | $134.24 | $207.08 | $56.12 – $1,033 |
| 7 | Aetna hmoposppo facility · fee schedule · outpatient | $167.80 | $258.85 | $70.15 – $1,291 |
| 8 | Aetna qualified health plan facility · fee schedule · outpatient | $167.80 | $258.85 | $70.15 – $1,291 |
| 9 | UnitedHealthcare hmo facility · fee schedule · outpatient | $175.95 | $271.43 | $73.55 – $1,354 |
| 10 | UnitedHealthcare ppo facility · fee schedule · outpatient | $175.95 | $271.43 | $73.55 – $1,354 |
| 11 | Cigna hmo facility · fee schedule · outpatient | $186.39 | $287.53 | $77.92 – $1,434 |
| 12 | Blue Cross Blue Shield hmopos facility · fee schedule · outpatient | $187.26 | $288.88 | $78.28 – $1,441 |
| 13 | Blue Cross Blue Shield epoppo facility · fee schedule · outpatient | $190.95 | $294.57 | $79.83 – $1,469 |
| 14 | Kaiser commercial facility · fee schedule · outpatient | $201.36 | $310.63 | $84.18 – $1,549 |
| 15 | Cigna ppo facility · fee schedule · outpatient | $208.14 | $321.08 | $87.01 – $1,601 |
| 16 | Blue Cross Blue Shield exchange hmo facility · fee schedule · outpatient | $213.40 | $329.21 | $89.21 – $1,642 |
| 17 | Humana choice care ppo facility · fee schedule · outpatient | $285.26 | $440.05 | $119.25 – $2,195 |
| 18 | MultiPlan ppo facility · fee schedule · outpatient | $285.26 | $440.05 | $119.25 – $2,195 |
| 19 | Phcs commercial facility · fee schedule · outpatient | $285.26 | $440.05 | $119.25 – $2,195 |
Last updated: Sep 11, 2026
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