RC 258
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
DEXTROSE 5 % IV SOLN
The hospitals that file a Excellus 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.
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60 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Alice Hyde Medical Center Malone, NY facility · percent of total billed charges · outpatientfrom % of charges | 3 | $9.10 | $2.46 – $53.56 |
| 2 | CLIFTON-FINE HEALTHCARE CORPORATION STAR LAKE, NY fee schedule · outpatient | 1 | $16.22 | $4.73 – $32.31 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 1 | $75.00 | $75.00 – $75.00 |
| 4 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · both | 1 | $75.00 | $75.00 – $75.00 |
| 5 | Central Community Hospital Elkader, IA facility · fee schedule · both | 1 | $75.00 | $75.00 – $75.00 |
| 6 | Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY facility · percent of total billed charges · outpatientfrom % of charges | 2 | $20.71 | $0.44 – $101.42 |
| 7 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $75.00 | $75.00 – $75.00 |
| 8 | Elizabethtown Community Hospital Elizabethtown, NY facility · percent of total billed charges · outpatientfrom % of charges | 3 | $4.49 | $3.34 – $6.61 |
| 9 | Highland Hospital Rochester, NY fee schedule · outpatient | 4 | $30.50 | $15.00 – $46.00 |
| 10 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $194.90 | $2.94 – $543.26 |
| 11 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763.00 | $763.00 – $763.00 |
| 12 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $204.54 | $2.94 – $548.36 |
| 13 | Johnson Memorial Hospital Stafford Springs, CT facility · fee schedule · both | 1 | $63.13 | $63.13 – $63.13 |
| 14 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $150.71 | $20.00 – $250.00 |
| 15 | Mercy Fitzgerald Hospital Darby, PA facility · fee schedule · both | 1 | $70.00 | $70.00 – $70.00 |
| 16 | Mercy Fitzgerald Hospital Darby, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $160.13 | $28.00 – $315.00 |
| 17 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $227.21 | $227.21 – $227.21 |
| 18 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $52.64 | $14.63 – $141.46 |
| 19 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $132.12 | $42.74 – $247.86 |
| 20 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $75.10 | $1.45 – $246.64 |
| 21 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $75.00 | $75.00 – $75.00 |
| 22 | Mercy Hospital of Franciscan Sisters Inc Oelwein, IA facility · fee schedule · both | 1 | $75.00 | $75.00 – $75.00 |
| 23 | Mercy Medical Center - Dubuque Dubuque, IA facility · fee schedule · both | 1 | $75.00 | $75.00 – $75.00 |
| 24 | Mercy Medical Center - Dyersville Dyersville, IA facility · fee schedule · both | 1 | $75.00 | $75.00 – $75.00 |
| 25 | Mercy Medical Center - New Hampton New Hampton, IA facility · fee schedule · both | 1 | $75.00 | $75.00 – $75.00 |
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