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
Grand Rapids, MI
See all hospitals reporting RC 258 →Price type
Mercy Health Saint Marys’s median price of $50 is 32% above the median hospital's median price ($38), higher than 59% 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: 20 payers, 23 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 preferred facility · percent of total billed charges · bothfrom % of charges | $33.70 | $68.64 | $1.33 – $225.42 |
| 2 | Anthem bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $36.87 | $75.10 | $1.45 – $246.64 |
| 3 | Blue Cross Blue Shield bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $36.87 | $75.10 | $1.45 – $246.64 |
| 4 | Carefirst bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $36.87 | $75.10 | $1.45 – $246.64 |
| 5 | Excellus bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $36.87 | $75.10 | $1.45 – $246.64 |
| 6 | Highmark bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $36.87 | $75.10 | $1.45 – $246.64 |
| 7 | Kaiser bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $36.87 | $75.10 | $1.45 – $246.64 |
| 8 | Premera bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $36.87 | $75.10 | $1.45 – $246.64 |
| 9 | Regence bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $36.87 | $75.10 | $1.45 – $246.64 |
| 10 | Wellmark bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $36.87 | $75.10 | $1.45 – $246.64 |
| 11 | Aetna aetna ppo facility · percent of total billed charges · bothfrom % of charges | $47.89 | $97.52 | $1.88 – $320.28 |
| 12 | Medical Mutual aetna ppo facility · percent of total billed charges · bothfrom % of charges | $47.89 | $97.52 | $1.88 – $320.28 |
| 13 | Caresource hap hmo facility · percent of total billed charges · bothfrom % of charges | $49.81 | $101.45 | $1.96 – $333.18 |
| 14 | Cigna priority health cigna ppo facility · percent of total billed charges · bothfrom % of charges | $55.63 | $113.30 | $2.19 – $372.10 |
| 15 | MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges | $55.66 | $113.36 | $2.19 – $372.30 |
| 16 | Phcs multiplan facility · percent of total billed charges · bothfrom % of charges | $55.66 | $113.36 | $2.19 – $372.30 |
| 17 | UnitedHealthcare united healthcare ppo facility · percent of total billed charges · bothfrom % of charges | $57.95 | $118.02 | $2.28 – $387.60 |
| 18 | Humana cofinity ppo facility · percent of total billed charges · bothfrom % of charges | $58.03 | $118.17 | $2.28 – $388.11 |
| 19 | Medcost cofinity ppo facility · percent of total billed charges · bothfrom % of charges | $58.03 | $118.17 | $2.28 – $388.11 |
| 20 | First Health first health ppo facility · percent of total billed charges · bothfrom % of charges | $60.39 | $122.98 | $2.38 – $403.92 |
| 21 | Humana humana lifesynch facility · percent of total billed charges · bothfrom % of charges | $76.25 | $155.28 | $3.00 – $510.00 |
| 22 | Magellan magellan facility · percent of total billed charges · bothfrom % of charges | $76.25 | $155.28 | $3.00 – $510.00 |
| 23 | UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges | $76.25 | $155.28 | $3.00 – $510.00 |
Last updated: Mar 31, 2026
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