RC 636
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 SOLUTION *BAG*
Jacksonville, TX
See all hospitals reporting RC 636 →Price type
Jacksonville Hospital, LLC’s median price of $48 is 18% below the median hospital's median price ($59), higher than 42% of the 1,987 hospitals reporting RC 636. 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, 28 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 | Aetna aetna coventry medicare replacement [102002] facility · percent of total billed charges · bothfrom % of charges | $256.33 | $233.01 | $101.21 – $403.65 |
| 2 | Blue Cross Blue Shield blue cross medicare advantage oos [116005] facility · percent of total billed charges · bothfrom % of charges | $256.33 | $233.01 | $101.21 – $403.65 |
| 3 | Cigna cigna medicare replacement [126500] facility · percent of total billed charges · bothfrom % of charges | $256.33 | $233.01 | $101.21 – $403.65 |
| 4 | Humana humana medicare advantage/ppo/gold [152503] facility · percent of total billed charges · bothfrom % of charges | $256.33 | $233.01 | $101.21 – $403.65 |
| 5 | Medicare medicare part a and b [163500] facility · percent of total billed charges · bothfrom % of charges | $256.33 | $233.01 | $101.21 – $403.65 |
| 6 | Medicare medicare part a only [163502] facility · percent of total billed charges · bothfrom % of charges | $256.33 | $233.01 | $101.21 – $403.65 |
| 7 | Medicare medicare part b only [163501] facility · percent of total billed charges · bothfrom % of charges | $256.33 | $233.01 | $101.21 – $403.65 |
| 8 | UnitedHealthcare uhc medicare advantage [206511] facility · percent of total billed charges · bothfrom % of charges | $256.33 | $233.01 | $101.21 – $403.65 |
| 9 | WellCare wellcare medicare [377501] facility · percent of total billed charges · bothfrom % of charges | $256.33 | $233.01 | $101.21 – $403.65 |
| 10 | UnitedHealthcare united healthcare texas exchange plan [206034] facility · percent of total billed charges · bothfrom % of charges | $371.68 | $337.87 | $146.76 – $585.29 |
| 11 | Aetna aetna [101529] facility · percent of total billed charges · bothfrom % of charges | $55.72 | $508.37 | $7.47 – $6,046 |
| 12 | Aetna meritain aetna [368500] facility · percent of total billed charges · bothfrom % of charges | $55.72 | $508.37 | $7.47 – $6,046 |
| 13 | Blue Cross Blue Shield blue cross hmo of texas [115504] facility · percent of total billed charges · bothfrom % of charges | $547.77 | $547.77 | $547.77 – $547.77 |
| 14 | Blue Cross Blue Shield blue cross advantage hmo of texas [115525] facility · percent of total billed charges · bothfrom % of charges | $640.64 | $640.64 | $640.64 – $640.64 |
| 15 | Blue Cross Blue Shield bcbs medicaid [116504] facility · percent of total billed charges · bothfrom % of charges | $24.04 | $870.30 | $0.18 – $105,122 |
| 16 | Cigna cigna healthspring medicaid replacement [394500] facility · percent of total billed charges · bothfrom % of charges | $24.04 | $870.30 | $0.18 – $105,122 |
| 17 | UnitedHealthcare uhc medicaid community plan [375501] facility · percent of total billed charges · bothfrom % of charges | $24.04 | $870.30 | $0.18 – $105,122 |
| 18 | Blue Cross Blue Shield blue cross preferred ppo of texas [115526] facility · percent of total billed charges · bothfrom % of charges | $968.54 | $968.54 | $968.54 – $968.54 |
| 19 | Blue Cross Blue Shield blue cross traditional of texas [115503] facility · percent of total billed charges · bothfrom % of charges | $968.54 | $968.54 | $968.54 – $968.54 |
| 20 | Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges | $37.00 | $1,088 | $0.17 – $101,469 |
| 21 | Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges | $37.00 | $1,088 | $0.17 – $101,469 |
| 22 | Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges | $37.00 | $1,088 | $0.17 – $101,469 |
| 23 | Cigna cigna ppo [126025] facility · percent of total billed charges · bothfrom % of charges | $51.79 | $1,881 | $0.39 – $226,479 |
| 24 | UnitedHealthcare uhc medica choice [206030] facility · percent of total billed charges · bothfrom % of charges | $73.25 | $2,154 | $0.34 – $200,908 |
| 25 | UnitedHealthcare united healthcare student svc [206012] facility · percent of total billed charges · bothfrom % of charges | $73.25 | $2,154 | $0.34 – $200,908 |
Last updated: Feb 12, 2026
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