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
31722-0019-31 - diatrizoate 30 mL Soln
Wayne, IN
See all hospitals reporting RC 255 →Price type
Dupont Hospital LLC’s median price of $38 is 30% below the median hospital's median price ($54), higher than 43% 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: 5 payers, 18 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 | Cigna cigna hmo facility · percent of total billed charges · inpatientfrom % of charges | $22.83 | $88.21 | $0.24 – $850.16 |
| 2 | Cigna cigna hmo facility · percent of total billed charges · outpatientfrom % of charges | $22.83 | $88.21 | $0.24 – $850.16 |
| 3 | Cigna cigna ppo facility · percent of total billed charges · inpatientfrom % of charges | $25.66 | $99.13 | $0.27 – $955.44 |
| 4 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $25.66 | $99.13 | $0.27 – $955.44 |
| 5 | Aetna aetna nbd facility · percent of total billed charges · inpatientfrom % of charges | $26.16 | $101.05 | $0.28 – $973.86 |
| 6 | Aetna aetna nbd facility · percent of total billed charges · outpatientfrom % of charges | $26.16 | $101.05 | $0.28 – $973.86 |
| 7 | Aetna aetna pssd jj facility · percent of total billed charges · inpatientfrom % of charges | $26.16 | $101.05 | $0.28 – $973.86 |
| 8 | Aetna aetna pssd jj facility · percent of total billed charges · outpatientfrom % of charges | $26.16 | $101.05 | $0.28 – $973.86 |
| 9 | Aetna aetna facility · percent of total billed charges · inpatientfrom % of charges | $31.60 | $122.07 | $0.34 – $1,177 |
| 10 | Aetna aetna facility · percent of total billed charges · outpatientfrom % of charges | $31.60 | $122.07 | $0.34 – $1,177 |
| 11 | UnitedHealthcare uhc apa facility · percent of total billed charges · outpatientfrom % of charges | $32.02 | $123.71 | $0.34 – $1,192 |
| 12 | UnitedHealthcare uhc options ppo facility · percent of total billed charges · outpatientfrom % of charges | $34.21 | $132.18 | $0.36 – $1,274 |
| 13 | Medical Mutual medical mutual of ohio facility · percent of total billed charges · inpatientfrom % of charges | $37.47 | $144.74 | $0.40 – $1,395 |
| 14 | Medical Mutual medical mutual of ohio facility · percent of total billed charges · outpatientfrom % of charges | $37.47 | $144.74 | $0.40 – $1,395 |
| 15 | MultiPlan multiplan ppo primary network facility · percent of total billed charges · inpatientfrom % of charges | $60.79 | $234.86 | $0.65 – $2,264 |
| 16 | MultiPlan multiplan ppo primary network facility · percent of total billed charges · outpatientfrom % of charges | $60.79 | $234.86 | $0.65 – $2,264 |
| 17 | MultiPlan multiplan ppo complimentary network facility · percent of total billed charges · inpatientfrom % of charges | $63.62 | $245.79 | $0.68 – $2,369 |
| 18 | MultiPlan multiplan ppo complimentary network facility · percent of total billed charges · outpatientfrom % of charges | $63.62 | $245.79 | $0.68 – $2,369 |
Last updated: Apr 1, 2026
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