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
HCHG STENT COATED/COVERED WO DELIVERY SYSTEM PR163
Rapids, MN
See all hospitals reporting HCPCS C1875 →Price type
Allina Health Systems’s median price of $25.1k is 668% above the median hospital's median price ($3.3k), higher than 96% of the 829 hospitals reporting HCPCS C1875. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 28 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 | UnitedHealthcare united healthcare (um) facility · case rate · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Bcbs Mn bc pmap (amu) facility · percent of total billed charges · outpatientfrom % of charges | $9.7k | $9.2k | $1.3k | 15% | — | $7.4k – $10.6k |
| 3 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $11.0k | $10.5k | $1.5k | 15% | — | $8.4k – $12.1k |
| 4 | Medica medica pmap (um) facility · percent of total billed charges · outpatientfrom % of charges | $12.2k | $11.6k | $1.7k | 15% | — | $9.3k – $13.3k |
| 5 | Bcbs Mn bc premier (m u) facility · percent of total billed charges · outpatientfrom % of charges | $17.8k | $17.0k | $2.5k | 15% | — | $13.6k – $19.5k |
| 6 | Bcbs Mn bc state health plan (mu) facility · percent of total billed charges · outpatientfrom % of charges | $18.0k | $17.1k | $2.5k | 15% | — | $13.7k – $19.6k |
| 7 | Aetna aetna elevate (amu) facility · percent of total billed charges · outpatientfrom % of charges | $19.3k | $18.4k | $2.7k | 15% | — | $14.7k – $21.1k |
| 8 | Aetna aetna elevate (amu) facility · percent of total billed charges · inpatientfrom % of charges | $20.2k | $19.2k | $2.8k | 15% | — | $15.4k – $22.1k |
| 9 | Aetna aetna performance (amu) facility · percent of total billed charges · outpatientfrom % of charges | $20.5k | $19.6k | $2.9k | 15% | — | $15.7k – $22.5k |
| 10 | Blue Cross Blue Shield bc aehp (mu) facility · percent of total billed charges · outpatientfrom % of charges | $20.9k | $19.9k | $2.9k | 15% | — | $16.0k – $22.9k |
| 11 | Aetna aetna performance (amu) facility · percent of total billed charges · inpatientfrom % of charges | $21.2k | $20.2k | $2.9k | 15% | — | $16.2k – $23.2k |
| 12 | Bcbs Mn bc high value/performance network (mu) facility · percent of total billed charges · outpatientfrom % of charges | $22.5k | $21.4k | $3.1k | 15% | — | $17.2k – $24.6k |
| 13 | Medica medica dual solutions (m) facility · percent of total billed charges · outpatientfrom % of charges | $24.3k | $23.2k | $3.4k | 15% | — | $18.6k – $26.6k |
| 14 | Medica medica elect (u m) facility · percent of total billed charges · inpatientfrom % of charges | $25.7k | $24.5k | $3.6k | 15% | — | $19.6k – $28.1k |
| 15 | Medica medica essentials (u m) facility · percent of total billed charges · inpatientfrom % of charges | $26.8k | $25.6k | $3.7k | 15% | — | $20.5k – $29.3k |
| 16 | Medica medica mhps (u m) facility · percent of total billed charges · inpatientfrom % of charges | $26.8k | $25.6k | $3.7k | 15% | — | $20.5k – $29.3k |
| 17 | Medica medica choice (u m) facility · percent of total billed charges · inpatientfrom % of charges | $28.2k | $26.9k | $3.9k | 15% | — | $21.6k – $30.9k |
| 18 | Aetna aetna direct network (amu) facility · percent of total billed charges · outpatientfrom % of charges | $29.9k | $28.5k | $4.2k | 15% | — | $22.9k – $32.7k |
| 19 | Aetna aetna direct network (amu) facility · percent of total billed charges · inpatientfrom % of charges | $31.2k | $29.7k | $4.3k | 15% | — | $23.8k – $34.1k |
| 20 | Bcbs Mn bc aware/blue plus (a m u) facility · percent of total billed charges · outpatientfrom % of charges | $32.2k | $30.6k | $4.5k | 15% | — | $24.6k – $35.2k |
| 21 | Medica medica elect (u m) facility · percent of total billed charges · outpatientfrom % of charges | $40.7k | $38.7k | $5.7k | 15% | — | $31.1k – $44.5k |
| 22 | Medica medica essentials (u m) facility · percent of total billed charges · outpatientfrom % of charges | $42.5k | $40.4k | $5.9k | 15% | — | $32.4k – $46.4k |
| 23 | Medica medica mhps (u m) facility · percent of total billed charges · outpatientfrom % of charges | $42.5k | $40.4k | $5.9k | 15% | — | $32.4k – $46.4k |
| 24 | Medica medica ubh pmap (m) facility · percent of total billed charges · outpatientfrom % of charges | $43.8k | $41.7k | $6.1k | 15% | — | $33.5k – $47.9k |
| 25 | Medica medica choice (u m) facility · percent of total billed charges · outpatientfrom % of charges | $44.7k | $42.6k | $6.2k | 15% | — | $34.1k – $48.9k |
Last updated: Jun 17, 2026
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