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 % IN WATER (D5W) INTRAVENOUS PIGGYBACK
Avon, OH
See all hospitals reporting RC 258 →Price type
Cleveland Clinic Avon Hospital’s median price of $0 is 100% below the median hospital's median price ($38), higher than 1% 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: 9 payers, 23 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.
Filter by billing methodology
Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Cigna all products facility · fee schedule · outpatient | $0.03 | $0.03 | $0.03 – $0.03 |
| 2 | Anthem ppo/hmo facility · percent of total billed charges · outpatientfrom % of charges | $0.05 | $1.40 | $0.01 – $8.01 |
| 3 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $0.06 | $1.79 | $0.01 – $10.25 |
| 4 | UnitedHealthcare all products facility · percent of total billed charges · outpatientfrom % of charges | $0.06 | $1.91 | $0.01 – $10.90 |
| 5 | Oscar all products facility · percent of total billed charges · outpatientfrom % of charges | $0.08 | $2.32 | $0.01 – $13.29 |
| 6 | Aetna acop facility · fee schedule · outpatient | $2.33 | $2.33 | $2.33 – $2.33 |
| 7 | Aetna asa_whirlpool_peia facility · fee schedule · outpatient | $2.56 | $2.56 | $2.56 – $2.56 |
| 8 | Oscar all products facility · percent of total billed charges · inpatientfrom % of charges | $0.10 | $2.96 | $0.01 – $16.96 |
| 9 | Aetna international facility · fee schedule · outpatient | $2.99 | $2.99 | $2.99 – $2.99 |
| 10 | Cigna all products facility · percent of total billed charges · outpatientfrom % of charges | $0.13 | $3.95 | $0.01 – $22.18 |
| 11 | Anthem traditional facility · percent of total billed charges · outpatientfrom % of charges | $0.15 | $4.61 | $0.02 – $26.34 |
| 12 | Optum all products transplant facility · percent of total billed charges · outpatientfrom % of charges | $0.15 | $4.65 | $0.02 – $26.60 |
| 13 | Anthem traditional facility · percent of total billed charges · inpatientfrom % of charges | $0.16 | $4.75 | $0.02 – $27.18 |
| 14 | Aetna acop facility · percent of total billed charges · outpatientfrom % of charges | $0.16 | $5.03 | $0.02 – $28.20 |
| 15 | Aetna international facility · percent of total billed charges · outpatientfrom % of charges | $0.17 | $5.38 | $0.02 – $30.17 |
| 16 | Aetna asa_whirlpool_peia facility · percent of total billed charges · outpatientfrom % of charges | $0.19 | $5.87 | $0.02 – $32.90 |
| 17 | Aetna all products facility · percent of total billed charges · bothfrom % of charges | $0.20 | $6.16 | $0.02 – $35.25 |
| 18 | MultiPlan all products facility · percent of total billed charges · bothfrom % of charges | $0.24 | $7.40 | $0.03 – $42.30 |
| 19 | Aetna qhp/ipf facility · percent of total billed charges · bothfrom % of charges | $0.27 | $8.22 | $0.03 – $47.00 |
| 20 | Anthem managed medicaid facility · case rate · outpatient | $44.43 | $32.35 | $8.20 – $44.43 |
| 21 | Molina managed medicaid facility · case rate · outpatient | $44.43 | $32.35 | $8.20 – $44.43 |
| 22 | Caresource managed medicaid facility · case rate · outpatient | $45.27 | $32.97 | $8.36 – $45.27 |
| 23 | UnitedHealthcare managed medicaid facility · case rate · outpatient | $45.27 | $32.97 | $8.36 – $45.27 |
Last updated: Jun 15, 2026
See Pharmacy charge pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.