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 SODIUM CHLORIDE 5 0 225 IV SOLN
Philadelphia, PA
See all hospitals reporting RC 258 →Price type
The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania’s median price of $19 is 49% below the median hospital's median price ($38), higher than 28% 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, 44 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 Nj horizon blue cross of nj-hmo pos and direct access facility · fee schedule · outpatient | $1.25 | $1.25 | $1.25 – $1.25 |
| 2 | Bcbs Nj horizon blue cross of nj-indemnity facility · fee schedule · outpatient | $1.25 | $1.25 | $1.25 – $1.25 |
| 3 | Bcbs Nj horizon blue cross of nj-ppo facility · fee schedule · outpatient | $1.25 | $1.25 | $1.25 – $1.25 |
| 4 | Cigna cigna new business facility · fee schedule · outpatient | $1.26 | $1.26 | $1.26 – $1.26 |
| 5 | UnitedHealthcare unitedhealthcare community (fka americhoice ma) facility · fee schedule · outpatient | $1.38 | $1.38 | $1.38 – $1.38 |
| 6 | Blue Cross Blue Shield ibc traditional facility · fee schedule · outpatient | $1.61 | $1.61 | $1.61 – $1.61 |
| 7 | Blue Cross Blue Shield keystone health plan east-ibc hmo facility · other · outpatient | $1.61 | $1.61 | $1.61 – $1.61 |
| 8 | Blue Cross Blue Shield personal choice-ibc ppo facility · other · outpatient | $1.61 | $1.61 | $1.61 – $1.61 |
| 9 | Aetna aetna commercial facility · case rate · outpatient | $2.51 | $2.51 | $2.51 – $2.51 |
| 10 | Aetna aetna commercial hmo with capitation facility · other · outpatient | $2.51 | $2.51 | $2.51 – $2.51 |
| 11 | Aetna aetna hmo facility · fee schedule · outpatient | $2.80 | $2.80 | $2.80 – $2.80 |
| 12 | Optum optum urn-transplant managed medicaid facility · other · outpatient | $3.70 | $51.40 | $2.31 – $247.17 |
| 13 | Aetna aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $5.45 | $82.19 | $3.40 – $364.33 |
| 14 | Aetna aetna commercial hmo with capitation facility · percent of total billed charges · outpatientfrom % of charges | $5.45 | $82.19 | $3.40 – $364.33 |
| 15 | Highmark highmark facility · other · outpatient | $6.00 | $83.44 | $3.75 – $401.25 |
| 16 | Bcbs Nj horizon blue cross of nj-hmo pos and direct access facility · percent of total billed charges · outpatientfrom % of charges | $6.48 | $97.76 | $4.05 – $433.35 |
| 17 | Cigna cigna facility · percent of total billed charges · outpatientfrom % of charges | $8.31 | $115.61 | $5.20 – $555.97 |
| 18 | Devoted devoted health medicare advantage facility · other · outpatient | $9.60 | $133.50 | $6.00 – $642.00 |
| 19 | UnitedHealthcare unitedhealthcare non options facility · percent of total billed charges · outpatientfrom % of charges | $9.70 | $134.84 | $6.06 – $648.42 |
| 20 | UnitedHealthcare unitedhealthcare new business facility · percent of total billed charges · outpatientfrom % of charges | $9.79 | $136.17 | $6.12 – $654.84 |
| 21 | Cigna cigna new business facility · percent of total billed charges · outpatientfrom % of charges | $9.24 | $139.37 | $5.77 – $617.76 |
| 22 | Cigna cigna lifesource facility · percent of total billed charges · outpatientfrom % of charges | $10.80 | $150.19 | $6.75 – $722.25 |
| 23 | First Health first health global facility · percent of total billed charges · inpatientfrom % of charges | $12.00 | $166.88 | $7.50 – $802.50 |
| 24 | First Health first health global facility · percent of total billed charges · outpatientfrom % of charges | $12.00 | $166.88 | $7.50 – $802.50 |
| 25 | Aetna aetna hmo facility · percent of total billed charges · outpatientfrom % of charges | $11.40 | $171.99 | $7.13 – $762.38 |
Last updated: Feb 10, 2026
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