RC 390
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
Platelet Aliq
Louis, MO
See all hospitals reporting RC 390 →Price type
Mercy Hospital South’s median price of $280 is 29% below the median hospital's median price ($397), higher than 31% of the 1,885 hospitals reporting RC 390. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 17 payers, 51 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 | Cigna hb samc cigna ifp facility · fee schedule · outpatient | $17.58 | $24.73 | $11.82 – $59.39 |
| 2 | Cigna hb samc cigna hmo facility · fee schedule · outpatient | $18.50 | $26.03 | $12.44 – $62.52 |
| 3 | Blue Cross Blue Shield hb samc anthem blue preferred eff 011520 facility · fee schedule · outpatient | $41.70 | $51.14 | $21.41 – $107.44 |
| 4 | Anthem hb samc anthem access choice facility · fee schedule · outpatient | $43.51 | $53.36 | $22.34 – $112.12 |
| 5 | Anthem hb samc anthem blue access facility · fee schedule · outpatient | $43.51 | $53.36 | $22.34 – $112.12 |
| 6 | Blue Cross Blue Shield hb samc anthem access choice facility · fee schedule · outpatient | $43.51 | $53.36 | $22.34 – $112.12 |
| 7 | Blue Cross Blue Shield hb samc anthem blue access facility · fee schedule · outpatient | $43.51 | $53.36 | $22.34 – $112.12 |
| 8 | Blue Cross Blue Shield hb samc anthem pathway/exchange eff 011520 facility · fee schedule · outpatient | $43.51 | $53.36 | $22.34 – $112.12 |
| 9 | Molina hb wash jefn linc samc molina healthchoice of il medicaid new 040125 facility · percent of total billed charges · outpatientfrom % of charges | $43.72 | $75.20 | $7.61 – $232.96 |
| 10 | Aetna hb wash jefn linc samc aetna better health of il medicaid new 040125 facility · percent of total billed charges · outpatientfrom % of charges | $100.88 | $173.54 | $17.55 – $537.60 |
| 11 | Medicaid hb wash jefn linc samc pcmh stod il medicaid facility · percent of total billed charges · outpatientfrom % of charges | $100.88 | $173.54 | $17.55 – $537.60 |
| 12 | Medicaid hb samc mo medicaid facility · fee schedule · outpatient | $146.09 | $228.41 | $33.46 – $575.99 |
| 13 | Tricare hb samc tricare - healthnet west facility · other · outpatient | $167.40 | $258.35 | $36.70 – $667.68 |
| 14 | Aetna hb samc aetna and coventry managed medicare facility · other · outpatient | $167.40 | $265.19 | $36.70 – $931.10 |
| 15 | Aetna hb samc medicare and 100% managed medicare facility · other · outpatient | $167.40 | $265.19 | $36.70 – $931.10 |
| 16 | Blue Cross Blue Shield hb samc medicare and 100% managed medicare facility · other · outpatient | $167.40 | $265.19 | $36.70 – $931.10 |
| 17 | Humana hb samc humana medicare w/seq ip 97% op 100% new 010124 facility · other · outpatient | $167.40 | $265.19 | $36.70 – $931.10 |
| 18 | Humana hb samc medicare and 100% managed medicare facility · other · outpatient | $167.40 | $265.19 | $36.70 – $931.10 |
| 19 | Medica hb samc medicare and 100% managed medicare facility · other · outpatient | $167.40 | $265.19 | $36.70 – $931.10 |
| 20 | Medicare hb samc medicare and 100% managed medicare facility · other · outpatient | $167.40 | $265.19 | $36.70 – $931.10 |
| 21 | UnitedHealthcare hb samc medicare and 100% managed medicare facility · other · outpatient | $167.40 | $265.19 | $36.70 – $931.10 |
| 22 | WellCare hb samc medicare and 100% managed medicare facility · other · outpatient | $167.40 | $265.19 | $36.70 – $931.10 |
| 23 | Cigna hb samc cigna managed medicare 010122 103% 010123 102% w/seq new 010122 facility · other · outpatient | $170.75 | $270.48 | $37.43 – $949.70 |
| 24 | WellCare hb samc wellcare harmony mcr 103% facility · other · outpatient | $172.52 | $273.30 | $37.82 – $959.57 |
| 25 | Devoted hb samc devoted health medicare advantage 104% w/seq facility · other · outpatient | $174.09 | $275.78 | $38.17 – $968.30 |
Last updated: Jun 10, 2026
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