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 10 % IV BOLUS
Stafford Springs, CT
See all hospitals reporting RC 258 →Price type
Johnson Memorial Hospital’s median price of $113 is 199% above the median hospital's median price ($38), higher than 86% 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: 15 payers, 31 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 | Anthem anthem individual pathway hmo ppo facility · fee schedule · both | $45.94 | $45.94 | $45.94 – $45.94 |
| 2 | Anthem anthem bluecare prime facility · fee schedule · both | $56.82 | $56.82 | $56.82 – $56.82 |
| 3 | Anthem anthem facility · fee schedule · both | $63.13 | $63.13 | $63.13 – $63.13 |
| 4 | Blue Cross Blue Shield anthem facility · fee schedule · both | $63.13 | $63.13 | $63.13 – $63.13 |
| 5 | Carefirst anthem facility · fee schedule · both | $63.13 | $63.13 | $63.13 – $63.13 |
| 6 | Excellus anthem facility · fee schedule · both | $63.13 | $63.13 | $63.13 – $63.13 |
| 7 | Highmark anthem facility · fee schedule · both | $63.13 | $63.13 | $63.13 – $63.13 |
| 8 | Kaiser anthem facility · fee schedule · both | $63.13 | $63.13 | $63.13 – $63.13 |
| 9 | Premera anthem facility · fee schedule · both | $63.13 | $63.13 | $63.13 – $63.13 |
| 10 | Regence anthem facility · fee schedule · both | $63.13 | $63.13 | $63.13 – $63.13 |
| 11 | Wellmark anthem facility · fee schedule · both | $63.13 | $63.13 | $63.13 – $63.13 |
| 12 | Aetna aetna whole health facility · percent of total billed charges · bothfrom % of charges | $85.80 | $84.63 | $12.48 – $156.00 |
| 13 | Cigna cigna facility · fee schedule · both | $96.05 | $96.05 | $96.05 – $96.05 |
| 14 | Aetna aetna facility · percent of total billed charges · bothfrom % of charges | $107.25 | $105.79 | $15.60 – $195.00 |
| 15 | Cigna evernorth facility · percent of total billed charges · bothfrom % of charges | $107.25 | $105.79 | $15.60 – $195.00 |
| 16 | UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges | $110.05 | $108.54 | $16.01 – $200.08 |
| 17 | MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges | $114.13 | $112.57 | $16.60 – $207.50 |
| 18 | Phcs multiplan facility · percent of total billed charges · bothfrom % of charges | $114.13 | $112.57 | $16.60 – $207.50 |
| 19 | Anthem anthem individual pathway hmo ppo facility · percent of total billed charges · bothfrom % of charges | $174.38 | $116.81 | $15.50 – $193.75 |
| 20 | Optum united healthcare behavioral health facility · percent of total billed charges · bothfrom % of charges | $137.50 | $135.63 | $20.00 – $250.00 |
| 21 | Anthem anthem bluecare prime facility · percent of total billed charges · bothfrom % of charges | $202.50 | $135.64 | $18.00 – $225.00 |
| 22 | Cigna cigna facility · percent of total billed charges · bothfrom % of charges | $205.34 | $137.54 | $18.25 – $228.15 |
| 23 | Anthem anthem facility · percent of total billed charges · bothfrom % of charges | $225.00 | $150.71 | $20.00 – $250.00 |
| 24 | Blue Cross Blue Shield anthem facility · percent of total billed charges · bothfrom % of charges | $225.00 | $150.71 | $20.00 – $250.00 |
| 25 | Carefirst anthem facility · percent of total billed charges · bothfrom % of charges | $225.00 | $150.71 | $20.00 – $250.00 |
Last updated: Mar 31, 2026
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