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
1166825 - DFBR GALLANT 1 CHMBR DF4 CNCT THK12MM 51X63MM 30CC 69GM
Summit, WI
See all hospitals reporting HCPCS C1722 →Price type
Aurora Medical Center Summit’s median price of $21.4k is 5% below the median hospital's median price ($22.5k), higher than 46% of the 1,347 hospitals reporting HCPCS C1722. 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, 21 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 hmo percent of total billed charges · outpatientfrom % of charges | $16.0k | $16.0k | — | — | — | $16.0k – $16.0k |
| 2 | UnitedHealthcare charter percent of total billed charges · outpatientfrom % of charges | $19.6k | $19.6k | — | — | — | $19.6k – $19.6k |
| 3 | UnitedHealthcare exchange percent of total billed charges · outpatientfrom % of charges | $19.6k | $19.6k | — | — | — | $19.6k – $19.6k |
| 4 | UnitedHealthcare hmo percent of total billed charges · outpatientfrom % of charges | $19.6k | $19.6k | — | — | — | $19.6k – $19.6k |
| 5 | UnitedHealthcare nexus percent of total billed charges · outpatientfrom % of charges | $19.6k | $19.6k | — | — | — | $19.6k – $19.6k |
| 6 | Anthem blue priority percent of total billed charges · outpatientfrom % of charges | $19.8k | $19.8k | — | — | — | $19.8k – $19.8k |
| 7 | Healthpartners employee trust fund percent of total billed charges · outpatientfrom % of charges | $19.8k | $19.8k | — | — | — | $19.8k – $19.8k |
| 8 | Molina commercial percent of total billed charges · outpatientfrom % of charges | $19.8k | $19.8k | — | — | — | $19.8k – $19.8k |
| 9 | Anthem blue preferred percent of total billed charges · outpatientfrom % of charges | $21.4k | $21.4k | — | — | — | $21.4k – $21.4k |
| 10 | Cigna ppo-gppo percent of total billed charges · outpatientfrom % of charges | $24.7k | $24.7k | — | — | — | $24.7k – $24.7k |
| 11 | Healthpartners broad percent of total billed charges · inpatientfrom % of charges | $24.7k | $24.7k | — | — | — | $24.7k – $24.7k |
| 12 | Healthpartners broad percent of total billed charges · outpatientfrom % of charges | $24.7k | $24.7k | — | — | — | $24.7k – $24.7k |
| 13 | Healthpartners robin percent of total billed charges · outpatientfrom % of charges | $24.7k | $24.7k | — | — | — | $24.7k – $24.7k |
| 14 | Aetna ppo percent of total billed charges · inpatientfrom % of charges | $27.2k | $27.2k | — | — | — | $27.2k – $27.2k |
| 15 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $27.2k | $27.2k | — | — | — | $27.2k – $27.2k |
| 16 | UnitedHealthcare ppo percent of total billed charges · inpatientfrom % of charges | $27.8k | $27.8k | — | — | — | $27.8k – $27.8k |
| 17 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $27.8k | $27.8k | — | — | — | $27.8k – $27.8k |
| 18 | Cigna ppo percent of total billed charges · inpatientfrom % of charges | $27.9k | $27.9k | — | — | — | $27.9k – $27.9k |
| 19 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $27.9k | $27.9k | — | — | — | $27.9k – $27.9k |
| 20 | Anthem ppo percent of total billed charges · inpatientfrom % of charges | $28.0k | $28.0k | — | — | — | $28.0k – $28.0k |
| 21 | Anthem ppo percent of total billed charges · outpatientfrom % of charges | $28.0k | $28.0k | — | — | — | $28.0k – $28.0k |
Last updated: Nov 21, 2025
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