RC 404
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
PET w CT Scan Skull Base to Midthigh Sub Scan
Wayne, IN
See all hospitals reporting RC 404 →Price type
St. Joseph Health System, LLC’s median price of $4.7k is 57% above the median hospital's median price ($3.0k), higher than 80% of the 1,508 hospitals reporting RC 404. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 13 payers, 43 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 node uhc mcr adv facility · fee schedule · outpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 2 | Tricare node tricare facility · fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 3 | Aetna node aetna mcr adv facility · fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 4 | Anthem node anthem in mcr adv facility · fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 5 | Humana node humana mcr adv facility · fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 6 | Anthem anthem in hip facility · fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 7 | Optum node united optum va ccn facility · per diem · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 8 | Devoted node devoted health mcr adv facility · fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 9 | Anthem node anthem essentials marketplace facility · fee schedule · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 10 | Anthem anthem in work comp facility · other · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 11 | Anthem anthem in medicaid facility · other · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 12 | Caresource caresource hhw in medicaid facility · other · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 13 | Caresource caresource in hip facility · other · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 14 | Humana humana pathways in medicaid facility · other · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 15 | Medicaid in medicaid facility · other · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 16 | UnitedHealthcare uhc hcc in medicaid facility · other · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 17 | UnitedHealthcare uhc pathways in medicaid facility · other · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 18 | Cigna cigna hmo facility · percent of total billed charges · inpatientfrom % of charges | $4.9k | $3.9k | $1.4k | 36% | — | $1.9k – $4.9k |
| 19 | Cigna cigna hmo facility · percent of total billed charges · outpatientfrom % of charges | $4.9k | $3.9k | $1.4k | 36% | — | $1.9k – $4.9k |
| 20 | Anthem anthem in ppo facility · percent of total billed charges · outpatientfrom % of charges | $5.5k | $4.4k | $1.6k | 36% | — | $2.1k – $5.5k |
| 21 | Cigna cigna ppo facility · percent of total billed charges · inpatientfrom % of charges | $5.5k | $4.4k | $1.6k | 36% | — | $2.2k – $5.5k |
| 22 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $5.5k | $4.4k | $1.6k | 36% | — | $2.2k – $5.5k |
| 23 | Anthem anthem in marketplace stld facility · fee schedule · outpatient | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 24 | Anthem anthem in healthsync facility · fee schedule · outpatient | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 25 | Aetna aetna all facility · percent of total billed charges · inpatientfrom % of charges | $7.0k | $5.6k | $2.0k | 36% | — | $2.7k – $7.0k |
Last updated: Apr 1, 2026
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