RC 250

General pharmacy charges at Forsyth Memorial Hospital, Inc.

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.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

I-131 SERUM ALBUMN PER5UCI(25

Winston-Salem, NC

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How this price compares nationally

Forsyth Memorial Hospital, Inc.’s median price of $202 is 999% above the median hospital's median price ($18), higher than 93% of the 1,901 hospitals reporting RC 250. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting RC 250 at Forsyth Memorial Hospital, Inc.

Negotiated rates from the hospital’s own file: 11 payers, 29 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	UnitedHealthcare all payer other · outpatient	$10.00	$10.00	$10.00 – $10.00
2	UnitedHealthcare all payer fee schedule · outpatient	$165.88	$493.47	$0.67 – $2,578
3	Blue Cross Blue Shield healthy blue medicaid fee schedule · outpatient	$54.73	$660.04	$0.18 – $3,230
4	UnitedHealthcare medicaid fee schedule · outpatient	$54.73	$660.04	$0.18 – $3,230
5	WellCare medicaid fee schedule · outpatient	$54.73	$660.04	$0.18 – $3,230
6	Blue Cross Blue Shield blue medicare fee schedule · outpatient	$707.82	$1,142	$707.82 – $2,009
7	Humana medicare fee schedule · outpatient	$707.82	$1,142	$707.82 – $2,009
8	UnitedHealthcare medicare fee schedule · outpatient	$707.82	$1,142	$707.82 – $2,009
9	Cigna healthspring fee schedule · outpatient	$729.05	$1,176	$729.05 – $2,069
10	Aetna medicare fee schedule · outpatient	$144.50	$1,306	$0.50 – $8,526
11	Cigna aca fee schedule · outpatient	$111.84	$1,349	$0.38 – $6,599
12	Caresource qualified health plan fee schedule · outpatient	$115.60	$1,394	$0.40 – $6,821
13	Cigna commercial fee schedule · outpatient	$510.79	$1,737	$0.59 – $10,129
14	Blue Cross Blue Shield blue home fee schedule · outpatient	$150.85	$1,793	$0.52 – $8,901
15	Blue Cross Blue Shield blue value fee schedule · outpatient	$156.06	$1,921	$0.54 – $9,208
16	Aetna commercial fee schedule · outpatient	$178.02	$2,147	$0.61 – $10,504
17	Blue Cross Blue Shield hmo fee schedule · outpatient	$198.54	$2,395	$0.68 – $11,715
18	Blue Cross Blue Shield ppo fee schedule · outpatient	$198.54	$2,395	$0.68 – $11,715
19	Humana commercial fee schedule · outpatient	$225.13	$2,715	$0.77 – $13,284
20	Aetna aca fee schedule · outpatient	$231.20	$2,788	$0.80 – $13,642
21	Aetna first health fee schedule · outpatient	$231.20	$2,788	$0.80 – $13,642
22	Aetna non-par products of apcn fee schedule · outpatient	$231.20	$2,788	$0.80 – $13,642
23	Aetna rental network products fee schedule · outpatient	$231.20	$2,788	$0.80 – $13,642
24	Aetna whole health non-multitier fee schedule · outpatient	$231.20	$2,788	$0.80 – $13,642
25	Medcost mbs fee schedule · outpatient	$245.65	$2,962	$0.85 – $14,494

Page 1 of 2 · 29 rates

Last updated: Mar 30, 2026

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