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
D5W/0.45NS w KCl and MGS04
Low
$3
Average
$21
Median
$14
High
$74
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
54 hospitals; the 90th percentile is 11.5× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
54 hospital rates
iThe hospitals that file a Blue Cross Blue Shield rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | ATHOL MEMORIAL HOSPITAL INCORPORATED Athol, MA fee schedule · outpatient | 3 | $9 | $9 | — | — | — | $9 – $9 |
| 2 | Benson Hospital Corporation Benson, AZ facility · fee schedule · outpatient | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 3 | Beth Israel Deaconess Hospital - Needham Needham, MA fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 4 | Beth Israel Deaconess Hospital - Plymouth Plymouth, MA fee schedule · outpatient | 2 | $9 | $9 | — | — | — | $9 – $9 |
| 5 | Beth Israel Deaconess Hospital-Milton Inc Milton, MA fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 6 | Beth Israel Deaconess Medical Center Boston, MA fee schedule · outpatient | 2 | $9 | $9 | — | — | — | $9 – $9 |
| 7 | HENRY HEYWOOD MEMORIAL HOSPITAL Gardner, MA fee schedule · outpatient | 3 | $9 | $9 | — | — | — | $9 – $9 |
| 8 | HonorHealth Florence Medical Center Florence, AZ facility · fee schedule · outpatient | 1 | $39 | $39 | $12 | 29% | — | $28 – $51 |
| 9 | Honorhealth Deer Valley Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $40 | $40 | $12 | 30% | — | $28 – $51 |
| 10 | Honorhealth Four Peaks Medical Center Mesa, AZ facility · fee schedule · outpatient | 1 | $39 | $39 | $12 | 29% | — | $28 – $51 |
| 11 | Honorhealth John C. Lincoln Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $40 | $40 | $12 | 30% | — | $28 – $51 |
| 12 | Honorhealth Scottsdale Osborn Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $40 | $40 | $12 | 30% | — | $28 – $51 |
| 13 | Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $40 | $40 | $12 | 30% | — | $28 – $51 |
| 14 | Honorhealth Scottsdale Thompson Peak Med Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $40 | $40 | $12 | 30% | — | $28 – $51 |
| 15 | Honorhealth Sonoran Crossing Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $40 | $40 | $12 | 30% | — | $28 – $51 |
| 16 | Kalkaska Memorial Health Center Kalkaska, MI professional · fee schedule · both | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 17 | Keck Hospital of USC Los Angeles, CA facility · fee schedule · outpatient | 2 | $26 | $26 | $0 | 2% | — | $25 – $26 |
| 18 | Lahey Hospital & Medical Center, Burlington Peabody, MA fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 19 | Mission Hospital Regional Med Center Laguna Beach, CA fee schedule · outpatient | 2 | $15 | $15 | — | — | — | $15 – $15 |
| 20 | Morton Hospital and Medical Center, Inc., Lifespan of Massachusetts - Taunton Inc Taunton, MA facility · fee schedule · outpatient | 3 | $11 | $11 | $0 | 2% | — | $11 – $11 |
| 21 | Munson Healthcare Cadillac Cadillac, MI professional · fee schedule · both | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 22 | Munson Healthcare Charlevoix Hospital Charlevoix, MI professional · fee schedule · both | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 23 | Munson Healthcare Grayling Grayling, MI professional · fee schedule · both | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 24 | Munson Healthcare Manistee Hospital Manistee, MI professional · fee schedule · both | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 25 | Munson Healthcare Otsego Memorial Hospital Gaylord, MI professional · fee schedule · both | 1 | $3 | $3 | — | — | — | $3 – $3 |
← Payers reporting HCPCS S5014 · Snapshot 20261113T090226Z-3ce6c0b8