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
HC Contrast Visipaque 320mg Iodine/Ml IV Solution
Lowell, MA
See all hospitals reporting RC 255 →Price type
Lowell General Hospital’s median price of $2 is 97% below the median hospital's median price ($54), higher than 11% 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: 8 payers, 12 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 | Aetna hb xr aetna hmo ppo lgh fee schedule · both | $0.41 | $0.31 | $0.12 – $0.41 |
| 2 | Cigna hb xr thp ppo lgh percent of total billed charges · bothfrom % of charges | $1.40 | $1.39 | $1.28 – $1.47 |
| 3 | Aetna hb xr aetna hmo ppo lgh percent of total billed charges · bothfrom % of charges | $3.22 | $3.21 | $2.95 – $3.39 |
| 4 | Blue Cross Blue Shield hb xr bcbsma ppo ppa lgh percent of total billed charges · bothfrom % of charges | $3.30 | $3.28 | $3.02 – $3.46 |
| 5 | Blue Cross Blue Shield hb xr bcbsma hmo lgh percent of total billed charges · bothfrom % of charges | $3.39 | $3.38 | $3.11 – $3.56 |
| 6 | Amerihealth Caritas hb xr non-contracted 35% of billed charges lgh percent of total billed charges · bothfrom % of charges | $1.29 | $16.16 | $1.12 – $115.50 |
| 7 | First Health hb xr non-contracted 35% of billed charges lgh percent of total billed charges · bothfrom % of charges | $1.29 | $16.16 | $1.12 – $115.50 |
| 8 | MultiPlan hb xr claritev lgh percent of total billed charges · bothfrom % of charges | $3.06 | $38.44 | $2.67 – $274.73 |
| 9 | Medicaid hb xr medicaid limited cmsp 100% percent of total billed charges · bothfrom % of charges | $3.68 | $46.17 | $3.21 – $330.00 |
| 10 | Cigna hb xr cigna lgh percent of total billed charges · bothfrom % of charges | $38.18 | $72.88 | $15.47 – $165.00 |
| 11 | UnitedHealthcare hb xr hphc self insured referral hmo pos ppo lgh other · both | $330.00 | $330.00 | $330.00 – $330.00 |
| 12 | UnitedHealthcare hb xr uhc lgh other · both | $330.00 | $330.00 | $330.00 – $330.00 |
Last updated: Apr 1, 2026
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