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
HC NM PET IMAGE W CT WHOLE BODY
Cedar Rapids, IA
See all hospitals reporting RC 404 →Price type
St Luke's Methodist Hospital’s median price of $2.1k is 31% below the median hospital's median price ($3.0k), higher than 29% of the 1,512 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: 7 payers, 14 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 medicare advantage case rate · outpatient | $1.4k | $1.5k | $259 | 18% | — | $1.2k – $2.1k |
| 2 | Molina medicare advantage case rate · outpatient | $1.4k | $1.5k | $259 | 18% | — | $1.2k – $2.1k |
| 3 | Wellmark medicare advantage case rate · outpatient | $1.4k | $1.5k | $259 | 18% | — | $1.2k – $2.1k |
| 4 | Humana medicare advantage case rate · outpatient | $1.4k | $1.5k | $266 | 18% | — | $1.3k – $2.2k |
| 5 | UnitedHealthcare medicare advantage case rate · outpatient | $1.4k | $1.5k | $266 | 18% | — | $1.3k – $2.2k |
| 6 | Medica commercial percent of total billed charges · outpatientfrom % of charges | $1.9k | $2.2k | $709 | 33% | — | $1.3k – $3.2k |
| 7 | Aetna hmo fee schedule · outpatient | $2.8k | $2.8k | $105 | 4% | — | $2.5k – $2.8k |
| 8 | Aetna ppo fee schedule · outpatient | $3.0k | $2.9k | $109 | 4% | — | $2.6k – $3.0k |
| 9 | Aetna hmo percent of total billed charges · outpatientfrom % of charges | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 10 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 11 | Cigna commercial percent of total billed charges · inpatientfrom % of charges | $3.0k | $3.3k | $1.1k | 32% | — | $2.2k – $4.7k |
| 12 | Cigna commercial percent of total billed charges · outpatientfrom % of charges | $3.0k | $3.3k | $1.1k | 32% | — | $2.2k – $4.7k |
| 13 | UnitedHealthcare hmo fee schedule · outpatient | $3.6k | $3.6k | $133 | 4% | — | $3.3k – $3.6k |
| 14 | UnitedHealthcare ppo fee schedule · outpatient | $3.6k | $3.6k | $133 | 4% | — | $3.3k – $3.6k |
Last updated: Jan 28, 2026
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