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
SILDENAFIL 0.067 MG/ML IN D5W INJ NEONATE
Papillion, NE
See all hospitals reporting RC 258 →Price type
Alegent Creighton Health’s median price of $87 is 130% above the median hospital's median price ($38), higher than 81% of the 1,497 hospitals reporting RC 258. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 9 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 | UnitedHealthcare medicaid|community plan fee schedule · outpatient | $31.32 | $27.93 | $17.91 – $34.56 |
| 2 | Medica commercial|all other plans fee schedule · outpatient | $87.00 | $77.58 | $49.75 – $96.00 |
| 3 | Medica commercial|chi health fee schedule · outpatient | $87.00 | $77.58 | $49.75 – $96.00 |
| 4 | Medica commercial|open access fee schedule · outpatient | $90.48 | $80.69 | $51.74 – $99.84 |
| 5 | Phcs commercial|all plans fee schedule · inpatient | $123.54 | $110.17 | $70.65 – $136.32 |
| 6 | UnitedHealthcare commercial|all plans fee schedule · outpatient | $128.76 | $114.82 | $73.63 – $142.08 |
| 7 | Phcs commercial|all plans fee schedule · outpatient | $130.50 | $116.38 | $74.63 – $144.00 |
| 8 | MultiPlan commercial|all plans fee schedule · inpatient | $147.90 | $131.89 | $84.58 – $163.20 |
| 9 | MultiPlan commercial|all plans fee schedule · outpatient | $147.90 | $131.89 | $84.58 – $163.20 |
Last updated: Feb 28, 2026
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