RC 258

Pharmacy charge

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

DEXTROSE 5 % IV SOLN

Payers reporting RC 258

63 payers file a negotiated rate for this code. Each is shown once, under the terms the most hospitals file it under; rates under different terms (billing class, payment method, setting) are never blended, so open a payer to see them all. Figures are hospital-level averages; the median is across hospitals.

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#
1	UnitedHealthcare fee schedule · outpatient · +28 other terms	169	$30.50	$66.29	$0.01 – $54,709
2	Cigna fee schedule · outpatient · +24 other terms	149	$4.59	$127.96	$0.01 – $137,247
3	Aetna fee schedule · outpatient · +24 other terms	124	$5.35	$77.71	$0.01 – $54,709
4	Anthem fee schedule · outpatient · +24 other terms	112	$5.52	$350.04	$0.01 – $1,140,825
5	Blue Cross Blue Shield fee schedule · outpatient · +28 other terms	104	$30.24	$23,878	$0.01 – $5,100,000
6	Humana fee schedule · outpatient · +22 other terms	87	$16.62	$91.15	$0.01 – $54,173
7	MultiPlan fee schedule · outpatient · +15 other terms	86	$111.27	$118.31	$0.01 – $5,852
8	Molina fee schedule · outpatient · +21 other terms	54	$3.62	$77.34	$0.01 – $53,637
9	Medcost percent of total billed charges · bothfrom % of charges · +5 other terms	44	$40.74	$57.98	$1.64 – $3,616
10	Beechstreet percent of total billed charges · outpatientfrom % of charges · +4 other terms	39	$153.24	$141.65	$0.04 – $2,945
11	First Health fee schedule · outpatient · +12 other terms	36	$93.66	$98.87	$0.34 – $3,749
12	Medica fee schedule · outpatient · +15 other terms	33	$4.60	$7.92	$0.01 – $3,078
13	Kaiser fee schedule · outpatient · +18 other terms	31	$79.59	$72.81	$0.01 – $2,238
14	Caresource fee schedule · outpatient · +18 other terms	29	$57.06	$136.85	$0.01 – $54,709
15	Regence facility · fee schedule · both · +9 other terms	27	$75.00	$81.59	$0.66 – $500.00
16	Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges	26	$33.21	$27.09	$0.93 – $215.76
17	Excellus facility · fee schedule · both · +5 other terms	26	$75.00	$120.70	$63.13 – $500.00
18	Premera facility · fee schedule · both · +6 other terms	26	$75.00	$117.72	$42.38 – $500.00
19	Carefirst facility · fee schedule · both · +4 other terms	25	$75.00	$128.81	$63.13 – $500.00
20	Highmark facility · fee schedule · both · +14 other terms	25	$75.00	$131.77	$63.13 – $500.00
21	Wellmark facility · fee schedule · both · +11 other terms	25	$75.00	$117.71	$63.13 – $500.00
22	Medicaid fee schedule · outpatient · +10 other terms	24	$116.45	$225.29	$1.00 – $5,844
23	Healthcare Highways facility · percent of total billed charges · bothfrom % of charges · +4 other terms	20	$21.55	$28.45	$2.61 – $139.40
24	Healthpartners fee schedule · outpatient · +8 other terms	18	$1.65	$1.78	$0.12 – $5.40
25	WellCare fee schedule · outpatient · +16 other terms	16	$2.96	$6.21	$0.04 – $1,154

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