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 300 MG IODINE/ML INTRAVENOUS SOLUTION
Fairmont 56031-4575
See all hospitals reporting RC 255 →Price type
Mayo Clinic Health System’s median price of $41 is 25% below the median hospital's median price ($54), higher than 44% 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: 15 payers, 33 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 | Medica medica prime solutions part b medicare advantage plan [150] facility · fee schedule · both | $0.46 | $0.46 | $0.46 – $0.46 |
| 2 | Healthpartners healthpartners medicare advantage plan part b [610] facility · fee schedule · both | $0.60 | $0.60 | $0.60 – $0.60 |
| 3 | Healthpartners medicaid critical access hospital healthpartners [1174] facility · percent of total billed charges · bothfrom % of charges | $9.03 | $26.76 | $1.25 – $202.80 |
| 4 | Ucare pps medicaid ucare [1186] facility · percent of total billed charges · bothfrom % of charges | $9.03 | $26.76 | $1.25 – $202.80 |
| 5 | Medica medica medicaid [1245] facility · percent of total billed charges · bothfrom % of charges | $21.52 | $64.33 | $3.02 – $491.40 |
| 6 | Medica medica medicare advantage plan minnesota senior health options msc+ cap [1073] facility · percent of total billed charges · bothfrom % of charges | $89.21 | $89.21 | $89.21 – $89.21 |
| 7 | Blue Cross Blue Shield winona health [1288] facility · percent of total billed charges · bothfrom % of charges | $36.89 | $109.35 | $5.10 – $828.75 |
| 8 | Blue Cross Blue Shield blue cross blue shield blue plus se with skemp [236] facility · percent of total billed charges · bothfrom % of charges | $37.52 | $111.21 | $5.19 – $842.89 |
| 9 | Medica deanhp by medica west mc hmo 88 pct [1265] facility · percent of total billed charges · bothfrom % of charges | $38.19 | $113.21 | $5.28 – $858.00 |
| 10 | Medica medica completehealth and engage [98] facility · percent of total billed charges · bothfrom % of charges | $38.19 | $113.21 | $5.28 – $858.00 |
| 11 | Ucare ucare ifp [1109] facility · percent of total billed charges · bothfrom % of charges | $38.19 | $113.21 | $5.28 – $858.00 |
| 12 | Blue Cross Blue Shield blue cross blue shield fep [870] facility · percent of total billed charges · bothfrom % of charges | $38.80 | $115.00 | $5.36 – $871.55 |
| 13 | Anthem blue cross blue shield blue plus [227] facility · percent of total billed charges · bothfrom % of charges | $39.49 | $117.07 | $5.46 – $887.25 |
| 14 | Blue Cross Blue Shield blue cross blue shield blue plus [227] facility · percent of total billed charges · bothfrom % of charges | $39.49 | $117.07 | $5.46 – $887.25 |
| 15 | Medica medica non mayo employees group [759] facility · percent of total billed charges · bothfrom % of charges | $39.93 | $118.35 | $5.52 – $897.00 |
| 16 | UnitedHealthcare united healthcare [269] facility · percent of total billed charges · bothfrom % of charges | $39.93 | $118.35 | $5.52 – $897.00 |
| 17 | Healthpartners all other plans [290] facility · percent of total billed charges · bothfrom % of charges | $40.36 | $119.64 | $5.58 – $906.75 |
| 18 | Medica united behavioral health [391] facility · percent of total billed charges · bothfrom % of charges | $40.36 | $119.64 | $5.58 – $906.75 |
| 19 | Optum united behavioral health [391] facility · percent of total billed charges · bothfrom % of charges | $40.36 | $119.64 | $5.58 – $906.75 |
| 20 | Medica medica choice [86] facility · percent of total billed charges · bothfrom % of charges | $40.80 | $120.92 | $5.64 – $916.50 |
| 21 | Aetna lcmc aetna [213] facility · percent of total billed charges · bothfrom % of charges | $41.23 | $122.21 | $5.70 – $926.25 |
| 22 | Blue Cross Blue Shield blue cross blue shield tiered network [886] facility · percent of total billed charges · bothfrom % of charges | $41.23 | $122.21 | $5.70 – $926.25 |
| 23 | Cigna all other plans [644] facility · percent of total billed charges · bothfrom % of charges | $41.23 | $122.21 | $5.70 – $926.25 |
| 24 | First Health lcmc aetna [213] facility · percent of total billed charges · bothfrom % of charges | $41.23 | $122.21 | $5.70 – $926.25 |
| 25 | Humana cigna [644] facility · percent of total billed charges · bothfrom % of charges | $41.23 | $122.21 | $5.70 – $926.25 |
Last updated: Mar 31, 2026
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