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 10 500 ML
Odessa, TX
See all hospitals reporting RC 258 →Price type
Odessa Texas Hospital Company LLC’s median price of $540 is 1327% above the median hospital's median price ($38), higher than 96% 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: 14 payers, 40 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 | Bcbs Tx bcbs of texas blue advantage hmo hix facility · fee schedule · outpatient | $23.75 | $20.60 | $0.54 – $57.45 |
| 2 | Bcbs Tx bcbs of texas hmo facility · fee schedule · outpatient | $28.09 | $23.97 | $0.63 – $64.01 |
| 3 | Bcbs Tx bcbs of texas ppo pos facility · fee schedule · outpatient | $31.00 | $27.53 | $0.70 – $81.36 |
| 4 | Bcbs Tx bcbs of texas traditional facility · fee schedule · outpatient | $33.92 | $28.39 | $0.77 – $71.72 |
| 5 | Bcbs Tx bcbs of texas blue advantage hmo hix facility · percent of total billed charges · outpatientfrom % of charges | $34.91 | $34.91 | $34.91 – $34.91 |
| 6 | Bcbs Tx bcbs of texas hmo facility · percent of total billed charges · outpatientfrom % of charges | $41.19 | $41.19 | $41.19 – $41.19 |
| 7 | Bcbs Tx bcbs of texas ppo pos facility · percent of total billed charges · outpatientfrom % of charges | $45.53 | $45.53 | $45.53 – $45.53 |
| 8 | Bcbs Tx bcbs of texas traditional facility · percent of total billed charges · outpatientfrom % of charges | $49.86 | $49.86 | $49.86 – $49.86 |
| 9 | Molina molina healthcare of new mexico medicaid facility · other · outpatient | $79.47 | $79.47 | $79.47 – $79.47 |
| 10 | Humana humana medicare advantage facility · fee schedule · outpatient | $202.89 | $202.89 | $202.89 – $202.89 |
| 11 | Aetna aetna medicare advantage facility · fee schedule · outpatient | $210.25 | $210.25 | $210.25 – $210.25 |
| 12 | Medicare medicare facility · fee schedule · outpatient | $210.25 | $210.25 | $210.25 – $210.25 |
| 13 | Superior Healthplan superior health plan medicare facility · fee schedule · outpatient | $210.25 | $210.25 | $210.25 – $210.25 |
| 14 | UnitedHealthcare united healthcare medicare advantage facility · per diem · outpatient | $210.25 | $210.25 | $210.25 – $210.25 |
| 15 | Tricare tricare facility · fee schedule · outpatient | $213.67 | $213.67 | $213.67 – $213.67 |
| 16 | UnitedHealthcare united healthcare exchange hix facility · fee schedule · outpatient | $320.50 | $320.50 | $320.50 – $320.50 |
| 17 | Superior Healthplan superior health plan medicaid facility · per diem · outpatient | $195.88 | $458.66 | $8.25 – $1,402 |
| 18 | Ambetter superior ambetter hix facility · other · outpatient | $252.13 | $602.38 | $11.44 – $1,953 |
| 19 | Bcbs Tn bcbs of texas tennessee facility · percent of total billed charges · outpatientfrom % of charges | $214.13 | $777.41 | $15.29 – $2,609 |
| 20 | Superior Healthplan superior health plan star uhrip facility · per diem · outpatient | $381.97 | $894.39 | $16.09 – $2,733 |
| 21 | Superior Healthplan superior health plan star plus uhrip facility · per diem · outpatient | $542.59 | $1,270 | $22.85 – $3,883 |
| 22 | Bcbs Tn bcbs of texas tennessee facility · percent of total billed charges · inpatientfrom % of charges | $364.34 | $1,323 | $26.01 – $4,439 |
| 23 | Aetna aetna trs (teachers retirement system) facility · percent of total billed charges · inpatientfrom % of charges | $426.67 | $1,549 | $30.46 – $5,198 |
| 24 | Aetna aetna trs (teachers retirement system) facility · percent of total billed charges · outpatientfrom % of charges | $426.67 | $1,549 | $30.46 – $5,198 |
| 25 | Cigna cigna nb network facility · percent of total billed charges · outpatientfrom % of charges | $824.32 | $1,926 | $34.57 – $5,899 |
Last updated: Mar 4, 2026
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