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
63323-0623-61 - Sodium Chloride 0.9% 0 / 100 mL S
Wayne, IN
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Dupont Hospital LLC’s median price of $188 is 398% above the median hospital's median price ($38), higher than 92% 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: 5 payers, 18 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 | Cigna cigna hmo facility · percent of total billed charges · inpatientfrom % of charges | $121.70 | $122.40 | $16.04 – $519.04 |
| 2 | Cigna cigna hmo facility · percent of total billed charges · outpatientfrom % of charges | $121.70 | $122.40 | $16.04 – $519.04 |
| 3 | Cigna cigna ppo facility · percent of total billed charges · inpatientfrom % of charges | $136.77 | $137.56 | $18.03 – $583.32 |
| 4 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $136.77 | $137.56 | $18.03 – $583.32 |
| 5 | Aetna aetna nbd facility · percent of total billed charges · inpatientfrom % of charges | $139.41 | $140.22 | $18.37 – $594.56 |
| 6 | Aetna aetna nbd facility · percent of total billed charges · outpatientfrom % of charges | $139.41 | $140.22 | $18.37 – $594.56 |
| 7 | Aetna aetna pssd jj facility · percent of total billed charges · inpatientfrom % of charges | $139.41 | $140.22 | $18.37 – $594.56 |
| 8 | Aetna aetna pssd jj facility · percent of total billed charges · outpatientfrom % of charges | $139.41 | $140.22 | $18.37 – $594.56 |
| 9 | Aetna aetna facility · percent of total billed charges · inpatientfrom % of charges | $168.42 | $169.39 | $22.20 – $718.30 |
| 10 | Aetna aetna facility · percent of total billed charges · outpatientfrom % of charges | $168.42 | $169.39 | $22.20 – $718.30 |
| 11 | UnitedHealthcare uhc apa facility · percent of total billed charges · outpatientfrom % of charges | $170.68 | $171.67 | $22.50 – $727.94 |
| 12 | UnitedHealthcare uhc options ppo facility · percent of total billed charges · outpatientfrom % of charges | $182.36 | $183.41 | $24.04 – $777.75 |
| 13 | Medical Mutual medical mutual of ohio facility · percent of total billed charges · inpatientfrom % of charges | $199.69 | $200.47 | $0.01 – $851.67 |
| 14 | Medical Mutual medical mutual of ohio facility · percent of total billed charges · outpatientfrom % of charges | $199.69 | $200.47 | $0.01 – $851.67 |
| 15 | MultiPlan multiplan ppo primary network facility · percent of total billed charges · inpatientfrom % of charges | $324.03 | $325.30 | $0.01 – $1,382 |
| 16 | MultiPlan multiplan ppo primary network facility · percent of total billed charges · outpatientfrom % of charges | $324.03 | $325.30 | $0.01 – $1,382 |
| 17 | MultiPlan multiplan ppo complimentary network facility · percent of total billed charges · inpatientfrom % of charges | $339.10 | $340.43 | $0.01 – $1,446 |
| 18 | MultiPlan multiplan ppo complimentary network facility · percent of total billed charges · outpatientfrom % of charges | $339.10 | $340.43 | $0.01 – $1,446 |
Last updated: Apr 1, 2026
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