RC 255

Pharmacy at Samaritan Hospital

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

IOPAMIDOL 200 MG IODINE/ML (41 %) INTRATHECAL SOLUTION

Troy, NY

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Pricing by billing methodology

Price type

How this price compares nationally

Samaritan Hospital’s median price of $36 is 35% below the median hospital's median price ($54), higher than 42% of the 1,205 hospitals reporting RC 255. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting RC 255 at Samaritan Hospital

Negotiated rates from the hospital’s own file: 15 payers, 26 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	UnitedHealthcare united healthcare medicaid harp chip facility · fee schedule · both	$10.30	$21.88	$1.55 – $103.21
2	Cigna cigna facility · fee schedule · both	$22.35	$45.01	$3.35 – $221.30
3	Aetna aetna facility · fee schedule · both	$32.78	$66.01	$4.92 – $324.57
4	Medical Mutual aetna facility · fee schedule · both	$32.78	$66.01	$4.92 – $324.57
5	UnitedHealthcare uhc essential plan medicaid facility · fee schedule · both	$35.00	$74.33	$5.25 – $350.70
6	Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
7	Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
8	Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
9	Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
10	Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
11	Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
12	Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
13	Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
14	Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
15	Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
16	Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
17	Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$49.93	$85.92	$15.48 – $222.53
18	UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges	$64.45	$121.07	$15.48 – $404.60
19	First Health first health facility · percent of total billed charges · bothfrom % of charges	$72.62	$124.98	$22.52 – $323.68
20	MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges	$81.70	$140.60	$25.34 – $364.14
21	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$81.70	$140.60	$25.34 – $364.14
22	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$81.70	$140.60	$25.34 – $364.14
23	Anthem empire medicaid facility · percent of total billed charges · bothfrom % of charges	$90.78	$156.22	$28.15 – $404.60
24	Anthem empire medicaid essential 1 2 3 4 facility · percent of total billed charges · bothfrom % of charges	$90.78	$156.22	$28.15 – $404.60
25	Excellus empire medicaid facility · percent of total billed charges · bothfrom % of charges	$90.78	$156.22	$28.15 – $404.60

Page 1 of 2 · 26 rates

Last updated: Mar 31, 2026

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