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 INJ 5%
MOUNTAIN CITY, TN
See all hospitals reporting RC 258 →Price type
Johnson County Community 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: 11 payers, 24 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 | Blue Cross Blue Shield blue cross ballad health employee fee schedule · both | $10.76 | $10.25 | $9.23 – $10.76 |
| 2 | Aetna aetna better health of virginia medicare percent of total billed charges · bothfrom % of charges | $14.03 | $15.55 | $4.64 – $54.71 |
| 3 | Aetna aetna healthcare medicare percent of total billed charges · bothfrom % of charges | $14.03 | $15.55 | $4.64 – $54.71 |
| 4 | UnitedHealthcare united healthcare medicare percent of total billed charges · bothfrom % of charges | $14.03 | $15.55 | $4.64 – $54.71 |
| 5 | WellCare wellcare medicare percent of total billed charges · bothfrom % of charges | $14.03 | $15.55 | $4.64 – $54.71 |
| 6 | Humana humana medicare percent of total billed charges · bothfrom % of charges | $14.25 | $15.79 | $4.71 – $55.59 |
| 7 | Blue Cross Blue Shield anthem medicare virginia percent of total billed charges · bothfrom % of charges | $14.45 | $16.01 | $4.78 – $56.35 |
| 8 | Molina molina healthcare medicare percent of total billed charges · bothfrom % of charges | $14.59 | $16.17 | $4.83 – $56.90 |
| 9 | Cigna cigna medicare percent of total billed charges · bothfrom % of charges | $14.73 | $16.32 | $4.87 – $57.45 |
| 10 | Devoted devoted health plan medicare percent of total billed charges · bothfrom % of charges | $14.73 | $16.32 | $4.87 – $57.45 |
| 11 | Ambetter ambetter percent of total billed charges · bothfrom % of charges | $15.48 | $17.15 | $5.12 – $60.37 |
| 12 | Medcost medcost vhn percent of total billed charges · bothfrom % of charges | $16.93 | $18.76 | $5.60 – $66.03 |
| 13 | Cigna cigna hmo percent of total billed charges · bothfrom % of charges | $18.82 | $20.85 | $6.22 – $73.39 |
| 14 | Cigna cigna open access plus percent of total billed charges · bothfrom % of charges | $18.82 | $20.85 | $6.22 – $73.39 |
| 15 | UnitedHealthcare uhc heritage select other · both | $18.92 | $20.96 | $6.26 – $73.77 |
| 16 | UnitedHealthcare tenncare united healthcare percent of total billed charges · bothfrom % of charges | $21.77 | $24.83 | $7.20 – $84.90 |
| 17 | Cigna cigna individual family plan percent of total billed charges · bothfrom % of charges | $22.45 | $24.87 | $7.42 – $87.54 |
| 18 | UnitedHealthcare uhc heritage river valley other · both | $22.69 | $25.14 | $7.50 – $88.48 |
| 19 | UnitedHealthcare united healthcare percent of total billed charges · bothfrom % of charges | $22.69 | $25.14 | $7.50 – $88.48 |
| 20 | Cigna cigna ppo percent of total billed charges · bothfrom % of charges | $23.37 | $25.89 | $7.73 – $91.12 |
| 21 | Aetna aetna percent of total billed charges · bothfrom % of charges | $30.87 | $34.20 | $10.21 – $120.37 |
| 22 | Blue Cross Blue Shield blue cross ballad health employee percent of total billed charges · bothfrom % of charges | $33.87 | $38.62 | $11.20 – $132.06 |
| 23 | First Health first health coventry percent of total billed charges · bothfrom % of charges | $36.29 | $40.21 | $12.00 – $141.50 |
| 24 | Blue Cross Blue Shield blue cross medicare percent of total billed charges · bothfrom % of charges | $36.41 | $40.34 | $12.04 – $141.99 |
Last updated: Mar 23, 2026
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