RC 804
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.
Original text from hospital filings
Peritoneal Dialysis Inpt Ccpd
Smith, AR
See all hospitals reporting RC 804 →Price type
Mercy Hospital Fort Smith’s median price of $396 is 47% below the median hospital's median price ($742), higher than 17% of the 482 hospitals reporting RC 804. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 16 payers, 28 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 | Blue Cross Blue Shield hb ftsm managed medicare facility · fee schedule · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 2 | Aetna hb ftsm ok managed medicaid facility · fee schedule · outpatient | $76 | $76 | — | — | — | $76 – $76 |
| 3 | Humana hb ftsm ok managed medicaid facility · fee schedule · outpatient | $76 | $76 | — | — | — | $76 – $76 |
| 4 | Medicaid hb ftsm ok medicaid facility · fee schedule · outpatient | $76 | $76 | — | — | — | $76 – $76 |
| 5 | Blue Cross Blue Shield hb ftsm bcbs exchange facility · percent of total billed charges · outpatientfrom % of charges | $329 | $329 | — | — | — | $329 – $329 |
| 6 | Medicaid hb ftsm mo medicaid facility · fee schedule · outpatient | $363 | $363 | — | — | — | $363 – $363 |
| 7 | Aetna hb ftsm managed medicare facility · other · outpatient | $396 | $396 | — | — | — | $396 – $396 |
| 8 | Blue Cross Blue Shield hb ftsm managed medicare facility · other · outpatient | $396 | $396 | — | — | — | $396 – $396 |
| 9 | First Health hb ftsm managed medicare facility · other · outpatient | $396 | $396 | — | — | — | $396 – $396 |
| 10 | Humana hb ftsm humana mcr facility · other · outpatient | $396 | $396 | — | — | — | $396 – $396 |
| 11 | Medica hb ftsm managed medicare facility · other · outpatient | $396 | $396 | — | — | — | $396 – $396 |
| 12 | Medicare hb ftsm medicare facility · other · outpatient | $396 | $396 | — | — | — | $396 – $396 |
| 13 | Tricare hb ftsm tricare facility · other · outpatient | $396 | $396 | — | — | — | $396 – $396 |
| 14 | UnitedHealthcare hb ftsm managed medicare facility · other · outpatient | $396 | $396 | — | — | — | $396 – $396 |
| 15 | UnitedHealthcare hb ftsm uhc mcr 100% facility · other · outpatient | $396 | $396 | — | — | — | $396 – $396 |
| 16 | WellCare hb ftsm novasys mcr 103% facility · other · outpatient | $409 | $409 | — | — | — | $409 – $409 |
| 17 | Devoted hb ftsm devoted health mcr facility · other · outpatient | $413 | $413 | — | — | — | $413 – $413 |
| 18 | Cigna hb ftsm healthspring cigna mcr 105% facility · other · outpatient | $417 | $417 | — | — | — | $417 – $417 |
| 19 | Ambetter hb ftsm novasys ambetter exchange facility · other · outpatient | $566 | $566 | — | — | — | $566 – $566 |
| 20 | Cigna hb ftsm cigna facility · percent of total billed charges · outpatientfrom % of charges | $625 | $625 | — | — | — | $625 – $625 |
| 21 | Anthem hb ftsm blue cross facility · percent of total billed charges · outpatientfrom % of charges | $647 | $647 | — | — | — | $647 – $647 |
| 22 | Blue Cross Blue Shield hb ftsm blue cross facility · percent of total billed charges · outpatientfrom % of charges | $647 | $647 | — | — | — | $647 – $647 |
| 23 | Optum hb ftsm,wldar,ozkar,prsar,bnvr uhc facility · percent of total billed charges · outpatientfrom % of charges | $658 | $658 | — | — | — | $658 – $658 |
| 24 | UnitedHealthcare hb ftsm,wldar,ozkar,prsar,bnvr uhc facility · percent of total billed charges · outpatientfrom % of charges | $658 | $658 | — | — | — | $658 – $658 |
| 25 | First Health hb ftsm first health_ccn facility · percent of total billed charges · outpatientfrom % of charges | $848 | $848 | — | — | — | $848 – $848 |
Last updated: Jun 8, 2026
See Continuous cycling peritoneal dialysis pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.