APC 875
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
sodium hyaluronate 10 mg/mL(mw 2.4 -3.6 million) S
Cambridge, MN
See all hospitals reporting APC 875 →Price type
Allina Health Systems’s median price of $108 is 1% below the median hospital's median price ($109), higher than 27% of the 225 hospitals reporting APC 875. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 4 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 allina aetna medicare (d) facility · fee schedule · outpatient | $100 | $100 | — | — | — | $100 – $100 |
| 2 | Medicare medicare (d) facility · fee schedule · outpatient | $105 | $105 | — | — | — | $105 – $105 |
| 3 | Medica medica medicare (d) facility · fee schedule · outpatient | $110 | $110 | — | — | — | $110 – $110 |
| 4 | Blue Cross Blue Shield bc medicare (d) facility · fee schedule · outpatient | $111 | $111 | — | — | — | $111 – $111 |
Last updated: Jun 16, 2026
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