RC 410
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
HC 94640 MDI/NEB INITIAL
San Antonio, TX
See all hospitals reporting RC 410 →Price type
Santa Rosa Hospital - Westover Hills’s median price of $174 is 21% below the median hospital's median price ($220), higher than 29% of the 1,964 hospitals reporting RC 410. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 12 payers, 91 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 | Aetna chip km percent of total billed charges · outpatientfrom % of charges | $52.80 | $68.72 | $6.71 – $616.00 |
| 2 | Aetna star km percent of total billed charges · outpatientfrom % of charges | $52.80 | $68.72 | $6.71 – $616.00 |
| 3 | Bcbs Tx star chip km percent of total billed charges · outpatientfrom % of charges | $52.80 | $68.72 | $6.71 – $616.00 |
| 4 | UnitedHealthcare chip km fee schedule · outpatient | $71.14 | $71.14 | $71.14 – $71.14 |
| 5 | UnitedHealthcare star km fee schedule · outpatient | $71.14 | $71.14 | $71.14 – $71.14 |
| 6 | UnitedHealthcare star plus km fee schedule · outpatient | $71.14 | $71.14 | $71.14 – $71.14 |
| 7 | Aetna chip km fee schedule · outpatient | $87.58 | $87.58 | $87.58 – $87.58 |
| 8 | Aetna star km fee schedule · outpatient | $87.58 | $87.58 | $87.58 – $87.58 |
| 9 | Bcbs Tx star chip km fee schedule · outpatient | $87.58 | $87.58 | $87.58 – $87.58 |
| 10 | Molina chip km fee schedule · outpatient | $87.58 | $87.58 | $87.58 – $87.58 |
| 11 | Molina star plus km fee schedule · outpatient | $87.58 | $87.58 | $87.58 – $87.58 |
| 12 | Humana choicecare fee schedule · outpatient | $106.79 | $89.61 | $42.36 – $109.65 |
| 13 | UnitedHealthcare chip km percent of total billed charges · outpatientfrom % of charges | $86.40 | $112.45 | $10.98 – $1,008 |
| 14 | UnitedHealthcare star km percent of total billed charges · outpatientfrom % of charges | $86.40 | $112.45 | $10.98 – $1,008 |
| 15 | UnitedHealthcare star plus km percent of total billed charges · outpatientfrom % of charges | $86.40 | $112.45 | $10.98 – $1,008 |
| 16 | Aetna mm fee schedule · outpatient | $156.01 | $127.31 | $7.66 – $218.05 |
| 17 | Devoted mm percent of total billed charges · outpatientfrom % of charges | $120.50 | $135.00 | $41.50 – $257.50 |
| 18 | Bcbs Tx mm fee schedule · outpatient | $190.98 | $143.91 | $23.00 – $218.05 |
| 19 | Humana gold choice mm fee schedule · outpatient | $190.98 | $143.91 | $23.00 – $218.05 |
| 20 | Humana gold plus mm fee schedule · outpatient | $190.98 | $143.91 | $23.00 – $218.05 |
| 21 | Molina medicare adv mm fee schedule · outpatient | $190.98 | $143.91 | $23.00 – $218.05 |
| 22 | UnitedHealthcare mm fee schedule · outpatient | $190.98 | $143.91 | $23.00 – $218.05 |
| 23 | WellCare mm fee schedule · outpatient | $190.98 | $143.91 | $23.00 – $218.05 |
| 24 | Cigna new business percent of total billed charges · outpatientfrom % of charges | $134.68 | $155.18 | $61.05 – $294.52 |
| 25 | Devoted mm fee schedule · outpatient | $206.26 | $155.42 | $24.84 – $235.49 |
Last updated: Jan 13, 2026
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