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
zzMAGNEVIST - GADOLINIUM-BASE NOS PER ML
Lancaster, OH
See all hospitals reporting RC 255 →Price type
Fairfield Medical Center’s median price of $203 is 272% above the median hospital's median price ($54), higher than 85% 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, 21 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 | Anthem anthem - blue traditional/blue access/blue preferred facility · fee schedule · outpatient | $3.29 | $2.50 | $0.33 – $3.87 |
| 2 | Anthem anthem - pathway x/ppo/hmo (on exchange) facility · fee schedule · outpatient | $3.29 | $2.50 | $0.33 – $3.87 |
| 3 | Anthem anthem ba oh i and ii - pathways ppo hmo facility · fee schedule · outpatient | $3.29 | $2.50 | $0.33 – $3.87 |
| 4 | Oscar oscar exchange facility · per diem · outpatient | $92.05 | $123.78 | $80.15 – $199.15 |
| 5 | Medical Mutual medical mutual ohio health hmo facility · percent of total billed charges · inpatientfrom % of charges | $118.35 | $159.15 | $103.05 – $256.05 |
| 6 | Medical Mutual medical mutual ohio health hmo facility · percent of total billed charges · outpatientfrom % of charges | $118.35 | $159.15 | $103.05 – $256.05 |
| 7 | Molina molina commercial exchange facility · other · outpatient | $131.50 | $176.83 | $114.50 – $284.50 |
| 8 | Anthem anthem - pathway x/ppo/hmo (on exchange) facility · percent of total billed charges · inpatientfrom % of charges | $136.23 | $183.20 | $118.62 – $294.74 |
| 9 | Anthem anthem ba oh i and ii - pathways ppo hmo facility · percent of total billed charges · inpatientfrom % of charges | $136.23 | $183.20 | $118.62 – $294.74 |
| 10 | Anthem anthem - blue traditional/blue access/blue preferred facility · percent of total billed charges · inpatientfrom % of charges | $146.49 | $196.99 | $127.55 – $316.93 |
| 11 | Aetna aetna - commercial facility · percent of total billed charges · inpatientfrom % of charges | $172.53 | $232.00 | $150.22 – $373.26 |
| 12 | Aetna aetna - commercial facility · percent of total billed charges · outpatientfrom % of charges | $172.53 | $232.00 | $150.22 – $373.26 |
| 13 | Medical Mutual medical mutual commercial facility · percent of total billed charges · inpatientfrom % of charges | $176.21 | $236.96 | $153.43 – $381.23 |
| 14 | Medical Mutual medical mutual commercial facility · percent of total billed charges · outpatientfrom % of charges | $176.21 | $236.96 | $153.43 – $381.23 |
| 15 | UnitedHealthcare united healthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $214.66 | $288.66 | $186.91 – $464.42 |
| 16 | Cigna cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $216.71 | $291.42 | $188.70 – $468.86 |
| 17 | Humana humana - commercial facility · percent of total billed charges · inpatientfrom % of charges | $249.85 | $335.98 | $217.55 – $540.55 |
| 18 | Humana humana - commercial facility · percent of total billed charges · outpatientfrom % of charges | $249.85 | $335.98 | $217.55 – $540.55 |
| 19 | MultiPlan multiplan facility · percent of total billed charges · inpatientfrom % of charges | $249.85 | $335.98 | $217.55 – $540.55 |
| 20 | MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges | $249.85 | $335.98 | $217.55 – $540.55 |
| 21 | Humana tricare - humana military facility · fee schedule · outpatient | $263.00 | $353.67 | $229.00 – $569.00 |
Last updated: Feb 26, 2026
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