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
INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML
Dalles, OR
See all hospitals reporting RC 255 →Price type
Mid Columbia Medical Center’s median price of $496 is 811% above the median hospital's median price ($54), higher than 93% 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: 9 payers, 18 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 | Molina molina mcr adv percent of total billed charges · outpatientfrom % of charges | $214.42 | $214.42 | $214.42 – $214.42 |
| 2 | Regence regence bcbs va triwest percent of total billed charges · outpatientfrom % of charges | $214.42 | $214.42 | $214.42 – $214.42 |
| 3 | Tricare tricare - all other plans percent of total billed charges · outpatientfrom % of charges | $214.42 | $214.42 | $214.42 – $214.42 |
| 4 | Humana humana - all plans percent of total billed charges · outpatientfrom % of charges | $225.14 | $225.14 | $225.14 – $225.14 |
| 5 | Regence regence bcbs mcr adv percent of total billed charges · outpatientfrom % of charges | $225.14 | $225.14 | $225.14 – $225.14 |
| 6 | Molina molina - all other plans percent of total billed charges · outpatientfrom % of charges | $235.86 | $235.86 | $235.86 – $235.86 |
| 7 | Molina molina mcaid percent of total billed charges · outpatientfrom % of charges | $321.75 | $421.84 | $124.28 – $968.12 |
| 8 | UnitedHealthcare uhc medicaid and chip percent of total billed charges · outpatientfrom % of charges | $321.75 | $421.84 | $124.28 – $968.12 |
| 9 | Regence regence bcbs healthy options mcaid percent of total billed charges · outpatientfrom % of charges | $386.10 | $506.20 | $149.14 – $1,162 |
| 10 | Regence regence bcbs - all other plans percent of total billed charges · outpatientfrom % of charges | $627.52 | $627.52 | $627.52 – $627.52 |
| 11 | First Health first health - all plans percent of total billed charges · outpatientfrom % of charges | $550.69 | $721.99 | $212.71 – $1,657 |
| 12 | Aetna aetna - all plans percent of total billed charges · outpatientfrom % of charges | $571.11 | $748.76 | $220.60 – $1,718 |
| 13 | Cigna cigna - all plans percent of total billed charges · outpatientfrom % of charges | $582.87 | $764.17 | $225.14 – $1,754 |
| 14 | MultiPlan multiplan/phcs - all plans percent of total billed charges · outpatientfrom % of charges | $587.82 | $770.66 | $227.05 – $1,769 |
| 15 | UnitedHealthcare uhc - all other plans percent of total billed charges · outpatientfrom % of charges | $587.82 | $770.66 | $227.05 – $1,769 |
| 16 | UnitedHealthcare uhc mcr adv percent of total billed charges · outpatientfrom % of charges | $587.82 | $770.66 | $227.05 – $1,769 |
| 17 | Humana humana - all plans fee schedule · outpatient | $1,219 | $1,249 | $586.18 – $1,973 |
| 18 | Regence regence bcbs - all other plans other · outpatient | $1,763 | $2,594 | $762.00 – $5,936 |
Last updated: May 13, 2026
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