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
Cleveland, OH
See all hospitals reporting RC 258 →Price type
Cleveland Clinic Children's Hospital For Rehabilitation’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, 26 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 | Oscar all products facility · percent of total billed charges · outpatientfrom % of charges | $0.04 | $0.12 | $0.01 – $2.31 |
| 2 | Oscar all products facility · percent of total billed charges · inpatientfrom % of charges | $0.05 | $0.15 | $0.01 – $2.94 |
| 3 | Cigna all products facility · percent of total billed charges · bothfrom % of charges | $0.05 | $0.16 | $0.01 – $3.02 |
| 4 | Anthem hpn facility · percent of total billed charges · outpatientfrom % of charges | $0.06 | $0.18 | $0.01 – $3.42 |
| 5 | Anthem hpn facility · percent of total billed charges · inpatientfrom % of charges | $0.06 | $0.18 | $0.01 – $3.53 |
| 6 | Anthem traditional facility · percent of total billed charges · outpatientfrom % of charges | $0.07 | $0.20 | $0.01 – $3.89 |
| 7 | Optum all products transplant facility · percent of total billed charges · outpatientfrom % of charges | $0.07 | $0.20 | $0.01 – $3.84 |
| 8 | Optum commercial chd care solutions facility · percent of total billed charges · bothfrom % of charges | $0.07 | $0.20 | $0.01 – $3.93 |
| 9 | UnitedHealthcare all products facility · percent of total billed charges · bothfrom % of charges | $0.07 | $0.20 | $0.01 – $3.92 |
| 10 | Anthem traditional facility · percent of total billed charges · inpatientfrom % of charges | $0.07 | $0.21 | $0.01 – $4.01 |
| 11 | Anthem ppo/hmo facility · percent of total billed charges · outpatientfrom % of charges | $0.07 | $0.21 | $0.01 – $4.02 |
| 12 | Anthem ppo/hmo facility · percent of total billed charges · inpatientfrom % of charges | $0.07 | $0.22 | $0.02 – $4.15 |
| 13 | Optum commercial crs care solutions facility · percent of total billed charges · bothfrom % of charges | $0.07 | $0.22 | $0.02 – $4.17 |
| 14 | Aetna all products facility · percent of total billed charges · bothfrom % of charges | $0.10 | $0.32 | $0.02 – $6.12 |
| 15 | Aetna acop facility · percent of total billed charges · outpatientfrom % of charges | $0.11 | $0.33 | $0.02 – $6.38 |
| 16 | Cigna all products psychiatrist facility · percent of total billed charges · outpatientfrom % of charges | $0.11 | $0.34 | $0.02 – $6.53 |
| 17 | Aetna asa_whirlpool_peia (hmo) facility · percent of total billed charges · outpatientfrom % of charges | $0.13 | $0.38 | $0.03 – $7.34 |
| 18 | MultiPlan all products facility · percent of total billed charges · bothfrom % of charges | $0.13 | $0.38 | $0.03 – $7.34 |
| 19 | Aetna international facility · percent of total billed charges · outpatientfrom % of charges | $0.13 | $0.40 | $0.03 – $7.75 |
| 20 | Aetna asa_whirlpool_peia (pos_epo_ppo) facility · percent of total billed charges · outpatientfrom % of charges | $0.13 | $0.40 | $0.03 – $7.78 |
| 21 | Aetna qhp/ipf facility · percent of total billed charges · bothfrom % of charges | $0.14 | $0.42 | $0.03 – $8.16 |
| 22 | Optum managed medicaid transplant facility · case rate · outpatient | $72.53 | $52.82 | $13.40 – $72.53 |
| 23 | Anthem managed medicaid facility · case rate · outpatient | $80.17 | $58.38 | $14.81 – $80.17 |
| 24 | Molina managed medicaid facility · case rate · outpatient | $80.17 | $58.38 | $14.81 – $80.17 |
| 25 | Caresource managed medicaid facility · case rate · outpatient | $81.69 | $59.49 | $15.09 – $81.69 |
Last updated: Jun 15, 2026
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