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
plasma protein fraction 5% Soln 50 mL Vial
Jersey Shore, PA
See all hospitals reporting RC 258 →Price type
Geisinger Jersey Shore Hospital’s median price of $15 is 61% below the median hospital's median price ($38), higher than 23% 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, 21 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 | Medicaid medicaid fee schedule · outpatient | $1.00 | $1.00 | $1.00 – $1.00 |
| 2 | UnitedHealthcare united healthcare - managed medicaid fee schedule · outpatient | $0.98 | $1.03 | $0.06 – $1.99 |
| 3 | UnitedHealthcare united healthcare - chip - managed medicare fee schedule · outpatient | $0.98 | $1.29 | $0.06 – $2.50 |
| 4 | Blue Cross Blue Shield highmark freedom blue - medicare advantage percent of total billed charges · outpatientfrom % of charges | $5.35 | $11.99 | $0.01 – $94.60 |
| 5 | Blue Cross Blue Shield capital - enhanced network rates percent of total billed charges · outpatientfrom % of charges | $6.05 | $13.54 | $0.01 – $106.81 |
| 6 | Aetna aetna - medicare advantage percent of total billed charges · outpatientfrom % of charges | $6.12 | $13.71 | $0.01 – $108.12 |
| 7 | Medicare medicare fee schedule · outpatient | $21.72 | $21.72 | $8.11 – $35.32 |
| 8 | Humana humana - medicare advantage fee schedule · outpatient | $21.93 | $21.93 | $8.19 – $35.67 |
| 9 | Blue Cross Blue Shield capital blue cross blue journey - medicare advantage fee schedule · outpatient | $22.15 | $22.15 | $8.27 – $36.03 |
| 10 | Cigna cigna percent of total billed charges · outpatientfrom % of charges | $12.24 | $27.41 | $0.02 – $216.24 |
| 11 | Aetna aetna percent of total billed charges · outpatientfrom % of charges | $18.54 | $41.52 | $0.04 – $327.51 |
| 12 | Blue Cross Blue Shield first priority health percent of total billed charges · outpatientfrom % of charges | $19.02 | $42.58 | $0.04 – $335.94 |
| 13 | Blue Cross Blue Shield highmark - access care ii percent of total billed charges · outpatientfrom % of charges | $19.02 | $42.58 | $0.04 – $335.94 |
| 14 | Blue Cross Blue Shield highmark - non access care ii percent of total billed charges · outpatientfrom % of charges | $19.02 | $42.58 | $0.04 – $335.94 |
| 15 | Aetna first health network percent of total billed charges · outpatientfrom % of charges | $19.35 | $43.34 | $0.04 – $341.93 |
| 16 | MultiPlan multiplan/private health care system percent of total billed charges · inpatientfrom % of charges | $20.40 | $45.68 | $0.04 – $360.40 |
| 17 | MultiPlan multiplan/private health care system percent of total billed charges · outpatientfrom % of charges | $20.40 | $45.68 | $0.04 – $360.40 |
| 18 | Ambetter ambetter fee schedule · outpatient | $52.12 | $52.12 | $19.46 – $84.77 |
| 19 | Blue Cross Blue Shield first priority health case rate · inpatient | $8,940 | $8,940 | $8,940 – $8,940 |
| 20 | Blue Cross Blue Shield highmark - access care ii case rate · inpatient | $15,104 | $15,104 | $15,104 – $15,104 |
| 21 | Blue Cross Blue Shield highmark - non access care ii case rate · inpatient | $15,635 | $15,635 | $15,635 – $15,635 |
Last updated: Jul 1, 2026
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