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 5 % IN WATER (D5W) INTRAVENOUS SOLUTION
Cedartown, GA
See all hospitals reporting RC 258 →Price type
Polk Medical Center Inc’s median price of $13 is 65% below the median hospital's median price ($38), higher than 21% 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, 26 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 | Caresource managed medicaid percent of total billed charges · outpatientfrom % of charges | $3.43 | $14.10 | $0.07 – $118.22 |
| 2 | Oscar commercial percent of total billed charges · outpatientfrom % of charges | $4.88 | $20.03 | $0.10 – $167.90 |
| 3 | Aetna medicare advantage percent of total billed charges · outpatientfrom % of charges | $5.00 | $20.54 | $0.10 – $172.20 |
| 4 | Anthem medicare advantage percent of total billed charges · outpatientfrom % of charges | $5.00 | $20.54 | $0.10 – $172.20 |
| 5 | Caresource medicare advantage percent of total billed charges · outpatientfrom % of charges | $5.00 | $20.54 | $0.10 – $172.20 |
| 6 | Cigna medicare advantage percent of total billed charges · outpatientfrom % of charges | $5.00 | $20.54 | $0.10 – $172.20 |
| 7 | Humana medicare advantage percent of total billed charges · outpatientfrom % of charges | $5.00 | $20.54 | $0.10 – $172.20 |
| 8 | UnitedHealthcare medicare advantage percent of total billed charges · outpatientfrom % of charges | $5.00 | $20.54 | $0.10 – $172.20 |
| 9 | WellCare medicare advantage percent of total billed charges · outpatientfrom % of charges | $5.00 | $20.54 | $0.10 – $172.20 |
| 10 | Clover medicare advantage percent of total billed charges · outpatientfrom % of charges | $6.50 | $26.70 | $0.13 – $223.86 |
| 11 | Ambetter marketplace exchange percent of total billed charges · outpatientfrom % of charges | $7.50 | $30.81 | $0.15 – $258.30 |
| 12 | Caresource marketplace exchange percent of total billed charges · outpatientfrom % of charges | $7.50 | $30.81 | $0.15 – $258.30 |
| 13 | Oscar commercial percent of total billed charges · inpatientfrom % of charges | $8.75 | $35.94 | $0.18 – $301.35 |
| 14 | Anthem hmo/pathway x percent of total billed charges · outpatientfrom % of charges | $12.50 | $51.35 | $0.25 – $430.50 |
| 15 | Anthem ppo percent of total billed charges · outpatientfrom % of charges | $12.50 | $51.35 | $0.25 – $430.50 |
| 16 | Cigna floyd county and rome city commercial percent of total billed charges · inpatientfrom % of charges | $13.25 | $54.43 | $0.27 – $456.33 |
| 17 | Cigna floyd county and rome city commercial percent of total billed charges · outpatientfrom % of charges | $13.25 | $54.43 | $0.27 – $456.33 |
| 18 | Cigna commercial percent of total billed charges · outpatientfrom % of charges | $15.00 | $61.62 | $0.30 – $516.60 |
| 19 | Cigna local plus commercial percent of total billed charges · outpatientfrom % of charges | $15.00 | $61.62 | $0.30 – $516.60 |
| 20 | Humana commercial percent of total billed charges · outpatientfrom % of charges | $16.25 | $66.75 | $0.33 – $559.65 |
| 21 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $17.00 | $67.78 | $0.32 – $585.48 |
| 22 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $17.50 | $71.89 | $0.35 – $602.70 |
| 23 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $17.50 | $71.89 | $0.35 – $602.70 |
| 24 | Anthem indemnity percent of total billed charges · inpatientfrom % of charges | $18.67 | $76.70 | $0.37 – $643.08 |
| 25 | Anthem indemnity percent of total billed charges · outpatientfrom % of charges | $18.67 | $76.70 | $0.37 – $643.08 |
Last updated: Nov 19, 2025
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