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 PR124
River Falls, WI
See all hospitals reporting HCPCS C1875 →Price type
Allina Health Systems’s median price of $27.1k is 727% above the median hospital's median price ($3.3k), higher than 96% of the 833 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: 6 payers, 17 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 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $11.0k | $10.5k | $1.5k | 15% | — | $8.4k – $12.1k |
| 2 | Medica medica pmap (r) facility · percent of total billed charges · outpatientfrom % of charges | $14.7k | $14.0k | $2.0k | 15% | — | $11.3k – $16.1k |
| 3 | Bcbs Mn bc pmap (r) facility · percent of total billed charges · outpatientfrom % of charges | $15.1k | $14.4k | $2.1k | 15% | — | $11.5k – $16.5k |
| 4 | Bcbs Mn bc premier (r) facility · percent of total billed charges · outpatientfrom % of charges | $18.1k | $17.2k | $2.5k | 15% | — | $13.8k – $19.8k |
| 5 | Bcbs Mn bc state health plan (r) facility · percent of total billed charges · outpatientfrom % of charges | $19.1k | $18.2k | $2.7k | 15% | — | $14.6k – $20.9k |
| 6 | Blue Cross Blue Shield bc aehp (r) facility · percent of total billed charges · outpatientfrom % of charges | $21.3k | $20.2k | $3.0k | 15% | — | $16.2k – $23.2k |
| 7 | Blue Cross Blue Shield bc medicare (r) facility · fee schedule · outpatient | $24.3k | $23.2k | $3.4k | 15% | — | $18.6k – $26.6k |
| 8 | Medica medica medicare (r) facility · fee schedule · outpatient | $24.3k | $23.2k | $3.4k | 15% | — | $18.6k – $26.6k |
| 9 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $24.7k | $23.5k | $3.4k | 15% | — | $18.8k – $27.0k |
| 10 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $33.6k | $32.0k | $4.7k | 15% | — | $25.6k – $36.7k |
| 11 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $33.9k | $32.3k | $4.7k | 15% | — | $25.9k – $37.1k |
| 12 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $36.3k | $34.5k | $5.0k | 15% | — | $27.7k – $39.7k |
| 13 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $36.6k | $34.9k | $5.1k | 15% | — | $28.0k – $40.0k |
| 14 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $46.0k | $43.8k | $6.4k | 15% | — | $35.1k – $50.3k |
| 15 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $46.0k | $43.8k | $6.4k | 15% | — | $35.1k – $50.3k |
| 16 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $46.3k | $44.1k | $6.4k | 15% | — | $35.4k – $50.7k |
| 17 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $46.8k | $44.6k | $6.5k | 15% | — | $35.7k – $51.2k |
Last updated: Jun 15, 2026
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