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
Dyersville, IA
See all hospitals reporting RC 258 →Price type
Mercy Medical Center - Dyersville’s median price of $124 is 228% above the median hospital's median price ($38), higher than 87% 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: 18 payers, 22 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 wellmark ppo facility · fee schedule · both | $75.00 | $75.00 | $75.00 – $75.00 |
| 2 | Blue Cross Blue Shield wellmark ppo facility · fee schedule · both | $75.00 | $75.00 | $75.00 – $75.00 |
| 3 | Carefirst wellmark ppo facility · fee schedule · both | $75.00 | $75.00 | $75.00 – $75.00 |
| 4 | Excellus wellmark ppo facility · fee schedule · both | $75.00 | $75.00 | $75.00 – $75.00 |
| 5 | Highmark wellmark ppo facility · fee schedule · both | $75.00 | $75.00 | $75.00 – $75.00 |
| 6 | Kaiser wellmark ppo facility · fee schedule · both | $75.00 | $75.00 | $75.00 – $75.00 |
| 7 | Premera wellmark ppo facility · fee schedule · both | $75.00 | $75.00 | $75.00 – $75.00 |
| 8 | Regence wellmark ppo facility · fee schedule · both | $75.00 | $75.00 | $75.00 – $75.00 |
| 9 | Wellmark wellmark hmo facility · fee schedule · both | $75.00 | $75.00 | $75.00 – $75.00 |
| 10 | Wellmark wellmark ppo facility · fee schedule · both | $75.00 | $75.00 | $75.00 – $75.00 |
| 11 | Wellmark wellmark medicare advantage facility · percent of total billed charges · bothfrom % of charges | $113.63 | $108.72 | $1.66 – $288.24 |
| 12 | UnitedHealthcare united healthcare medicare advantage facility · percent of total billed charges · bothfrom % of charges | $121.69 | $116.42 | $1.78 – $308.67 |
| 13 | UnitedHealthcare united healthcare deere premier facility · percent of total billed charges · bothfrom % of charges | $143.50 | $137.29 | $2.10 – $364.00 |
| 14 | Molina molina medicaid facility · percent of total billed charges · bothfrom % of charges | $144.28 | $138.04 | $2.11 – $365.98 |
| 15 | Aetna aetna facility · percent of total billed charges · bothfrom % of charges | $169.54 | $162.20 | $2.48 – $430.04 |
| 16 | First Health aetna facility · percent of total billed charges · bothfrom % of charges | $169.54 | $162.20 | $2.48 – $430.04 |
| 17 | Medical Mutual aetna facility · percent of total billed charges · bothfrom % of charges | $169.54 | $162.20 | $2.48 – $430.04 |
| 18 | Cigna midlands choice ppo facility · percent of total billed charges · bothfrom % of charges | $184.50 | $176.52 | $2.70 – $468.00 |
| 19 | Medica midlands choice ppo facility · percent of total billed charges · bothfrom % of charges | $184.50 | $176.52 | $2.70 – $468.00 |
| 20 | MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges | $184.50 | $176.52 | $2.70 – $468.00 |
| 21 | UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges | $184.50 | $176.52 | $2.70 – $468.00 |
| 22 | Ambetter ambetter marketplace facility · percent of total billed charges · bothfrom % of charges | $192.86 | $184.52 | $2.82 – $489.22 |
Last updated: Mar 31, 2026
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