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
GADOTERATE MEGLUMINE 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION
Grand Rapids, MI
See all hospitals reporting RC 255 →Price type
Mercy Health Saint Marys’s median price of $69 is 26% above the median hospital's median price ($54), higher than 54% 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: 20 payers, 23 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 bcbs trad / trust facility · fee schedule · both | $24.40 | $27.63 | $9.58 – $48.79 |
| 2 | Blue Cross Blue Shield bcbs trad / trust facility · fee schedule · both | $24.40 | $27.63 | $9.58 – $48.79 |
| 3 | Carefirst bcbs trad / trust facility · fee schedule · both | $24.40 | $27.63 | $9.58 – $48.79 |
| 4 | Excellus bcbs trad / trust facility · fee schedule · both | $24.40 | $27.63 | $9.58 – $48.79 |
| 5 | Highmark bcbs trad / trust facility · fee schedule · both | $24.40 | $27.63 | $9.58 – $48.79 |
| 6 | Kaiser bcbs trad / trust facility · fee schedule · both | $24.40 | $27.63 | $9.58 – $48.79 |
| 7 | Premera bcbs trad / trust facility · fee schedule · both | $24.40 | $27.63 | $9.58 – $48.79 |
| 8 | Regence bcbs trad / trust facility · fee schedule · both | $24.40 | $27.63 | $9.58 – $48.79 |
| 9 | Wellmark bcbs trad / trust facility · fee schedule · both | $24.40 | $27.63 | $9.58 – $48.79 |
| 10 | Aetna aetna ppo facility · fee schedule · both | $46.80 | $51.26 | $17.16 – $93.60 |
| 11 | Medical Mutual aetna ppo facility · fee schedule · both | $46.80 | $51.26 | $17.16 – $93.60 |
| 12 | Aetna aetna preferred facility · percent of total billed charges · bothfrom % of charges | $75.58 | $94.64 | $25.19 – $222.33 |
| 13 | Caresource hap hmo facility · percent of total billed charges · bothfrom % of charges | $111.71 | $139.89 | $37.24 – $328.61 |
| 14 | Cigna priority health cigna ppo facility · percent of total billed charges · bothfrom % of charges | $124.76 | $156.22 | $41.59 – $366.99 |
| 15 | MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges | $124.83 | $156.31 | $41.61 – $367.19 |
| 16 | Phcs multiplan facility · percent of total billed charges · bothfrom % of charges | $124.83 | $156.31 | $41.61 – $367.19 |
| 17 | UnitedHealthcare united healthcare ppo facility · percent of total billed charges · bothfrom % of charges | $129.96 | $162.73 | $43.32 – $382.28 |
| 18 | Humana cofinity ppo facility · percent of total billed charges · bothfrom % of charges | $130.13 | $162.95 | $43.38 – $382.78 |
| 19 | Medcost cofinity ppo facility · percent of total billed charges · bothfrom % of charges | $130.13 | $162.95 | $43.38 – $382.78 |
| 20 | First Health first health ppo facility · percent of total billed charges · bothfrom % of charges | $135.43 | $169.58 | $45.14 – $398.38 |
| 21 | Humana humana lifesynch facility · percent of total billed charges · bothfrom % of charges | $171.00 | $214.12 | $57.00 – $503.00 |
| 22 | Magellan magellan facility · percent of total billed charges · bothfrom % of charges | $171.00 | $214.12 | $57.00 – $503.00 |
| 23 | UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges | $171.00 | $214.12 | $57.00 – $503.00 |
Last updated: Mar 31, 2026
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