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
gadobutrol 1 mmol/mL (604.72 mg/mL) solution
Manning, SC
See all hospitals reporting RC 255 →Price type
McLeod Health’s median price of $1 is 99% below the median hospital's median price ($54), higher than 3% 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: 7 payers, 11 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 | Tricare dha fee schedule · both | $0.25 | $0.32 | $0.07 – $17.66 |
| 2 | Blue Cross Blue Shield medicaid fee schedule · both | $0.48 | $0.58 | $0.30 – $35.69 |
| 3 | Medicaid medicaid fee schedule · both | $0.48 | $0.58 | $0.30 – $35.69 |
| 4 | Molina medicaid fee schedule · both | $0.51 | $0.61 | $0.31 – $37.47 |
| 5 | Cigna commercial fee schedule · both | $0.61 | $0.79 | $0.17 – $43.87 |
| 6 | Blue Cross Blue Shield hix percent of total billed charges · bothfrom % of charges | $88.40 | $116.87 | $0.20 – $12,959 |
| 7 | Blue Cross Blue Shield state percent of total billed charges · bothfrom % of charges | $240.25 | $339.32 | $0.50 – $2,095 |
| 8 | UnitedHealthcare commercial percent of total billed charges · bothfrom % of charges | $351.78 | $465.09 | $0.78 – $51,572 |
| 9 | Aetna commercial percent of total billed charges · bothfrom % of charges | $360.80 | $477.02 | $0.80 – $52,894 |
| 10 | Blue Cross Blue Shield preferred percent of total billed charges · bothfrom % of charges | $457.25 | $478.36 | $304.84 – $887.00 |
| 11 | Blue Cross Blue Shield choice percent of total billed charges · bothfrom % of charges | $547.43 | $572.70 | $364.95 – $1,062 |
Last updated: Jul 20, 2026
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