RC 390
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
PLATELETS PHERESIS PATH REDU EA
Salem, IN
See all hospitals reporting RC 390 →Price type
St. Vincent Salem Hospital, Inc.’s median price of $825 is 108% above the median hospital's median price ($397), higher than 90% of the 1,885 hospitals reporting RC 390. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 14 payers, 73 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 | Anthem 4090_anthem behavioral medicaid replacement outpatient 20200201 fee schedule · outpatient | $207.26 | $207.26 | $207.26 – $207.26 |
| 2 | Anthem 7373_anthem medicaid replacement outpatient 20230101 fee schedule · outpatient | $278.73 | $278.73 | $278.73 – $278.73 |
| 3 | Anthem 8255_anthem connect medicaid replacement outpatient 20240101 fee schedule · outpatient | $278.73 | $278.73 | $278.73 – $278.73 |
| 4 | Anthem 8879_anthem connect medicaid replacement asc outpatient 20240401 fee schedule · outpatient | $278.73 | $278.73 | $278.73 – $278.73 |
| 5 | Aetna 8373_aetna medicare replacement vsin 20240701 percent of total billed charges · bothfrom % of charges | $276.60 | $313.43 | $68.80 – $673.40 |
| 6 | WellCare 8382_wellcare medicare replacement vsin 20240701 percent of total billed charges · bothfrom % of charges | $276.60 | $313.43 | $68.80 – $673.40 |
| 7 | Humana 8683_humana ppo medicare replacement inpatient svin 20241001 percent of total billed charges · outpatientfrom % of charges | $345.75 | $391.78 | $86.00 – $841.75 |
| 8 | Ambetter 8380_mhs cenpatico-ambetter marketplace vsin 20240701 percent of total billed charges · outpatientfrom % of charges | $401.07 | $454.47 | $99.76 – $976.43 |
| 9 | Anthem 8374_anthem medicare replacement vsin 20240701 percent of total billed charges · outpatientfrom % of charges | $401.07 | $454.47 | $99.76 – $976.43 |
| 10 | Caresource 9217_caresource marketplace vsin 20240701 percent of total billed charges · outpatientfrom % of charges | $401.07 | $454.47 | $99.76 – $976.43 |
| 11 | Humana 8375_humana gold choice medicare replacement vsin 20240701 percent of total billed charges · outpatientfrom % of charges | $401.07 | $454.47 | $99.76 – $976.43 |
| 12 | Humana 8376_humana ppo medicare replacement vsin 20240701 percent of total billed charges · outpatientfrom % of charges | $401.07 | $454.47 | $99.76 – $976.43 |
| 13 | UnitedHealthcare 8381_united healthcare medicare replacement vsin 20240701 percent of total billed charges · outpatientfrom % of charges | $401.07 | $454.47 | $99.76 – $976.43 |
| 14 | Ambetter 3454_mhs cenpatico ambetter outpatient vsin 20200701 percent of total billed charges · outpatientfrom % of charges | $428.73 | $485.81 | $106.64 – $1,044 |
| 15 | Devoted 8137_devoted health medicare advantage vsin 20231120 percent of total billed charges · outpatientfrom % of charges | $456.39 | $517.15 | $113.52 – $1,111 |
| 16 | Anthem 9319_anthem healthsync hmo vsin 20250101 percent of total billed charges · outpatientfrom % of charges | $608.52 | $689.54 | $151.36 – $1,481 |
| 17 | Anthem 9323_anthem pathway x vsin 20250101 percent of total billed charges · outpatientfrom % of charges | $608.52 | $689.54 | $151.36 – $1,481 |
| 18 | Anthem 9356_anthem short term limited duration vsin 20250101 percent of total billed charges · outpatientfrom % of charges | $608.52 | $689.54 | $151.36 – $1,481 |
| 19 | Anthem 9320_anthem healthsync pos vsin 20250101 percent of total billed charges · outpatientfrom % of charges | $663.84 | $752.22 | $165.12 – $1,616 |
| 20 | Anthem 9321_anthem hmo pos vsin 20250101 percent of total billed charges · outpatientfrom % of charges | $788.31 | $893.26 | $196.08 – $1,919 |
| 21 | Aetna 3697_aetna svin vfin vhin 20210101 percent of total billed charges · outpatientfrom % of charges | $802.14 | $908.93 | $199.52 – $1,953 |
| 22 | Anthem 9322_anthem pathway vsin 20250101 percent of total billed charges · outpatientfrom % of charges | $815.97 | $924.60 | $202.96 – $1,987 |
| 23 | Anthem 9324_anthem preferred vsin 20250101 percent of total billed charges · outpatientfrom % of charges | $815.97 | $924.60 | $202.96 – $1,987 |
| 24 | Humana 8829_humana choice care network vein 20241001 percent of total billed charges · outpatientfrom % of charges | $843.63 | $955.95 | $209.84 – $2,054 |
| 25 | Humana 8830_humana choice care vein 20241001 percent of total billed charges · outpatientfrom % of charges | $843.63 | $955.95 | $209.84 – $2,054 |
Last updated: Jan 1, 2026
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