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
STENT POLARIS 7FX26CM W/O WIRE 1/EA M0061921430
Peoria, IL
See all hospitals reporting HCPCS C1758 →Price type
Proctor Community Hospital’s median price of $127 is 97% above the median hospital's median price ($65), higher than 73% of the 1,572 hospitals reporting HCPCS C1758. 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, 19 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 va ccn fee schedule · inpatient | $33 | $33 | — | — | — | $33 – $33 |
| 2 | UnitedHealthcare va ccn fee schedule · outpatient | $33 | $33 | — | — | — | $33 – $33 |
| 3 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $71 | $71 | — | — | — | $71 – $71 |
| 4 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 5 | Aetna Better Health managed medicaid percent of total billed charges · inpatientfrom % of charges | $102 | $310 | $949 | 306% | — | $1 – $7.9k |
| 6 | Aetna Better Health managed medicaid percent of total billed charges · outpatientfrom % of charges | $102 | $310 | $949 | 306% | — | $1 – $7.9k |
| 7 | Molina managed medicaid percent of total billed charges · inpatientfrom % of charges | $122 | $372 | $1.1k | 306% | — | $1 – $9.5k |
| 8 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $122 | $372 | $1.1k | 306% | — | $1 – $9.5k |
| 9 | Molina medicare-medicaid (mmai/dual) percent of total billed charges · inpatientfrom % of charges | $122 | $372 | $1.1k | 306% | — | $1 – $9.5k |
| 10 | Molina medicare-medicaid (mmai/dual) percent of total billed charges · outpatientfrom % of charges | $122 | $372 | $1.1k | 306% | — | $1 – $9.5k |
| 11 | Blue Cross Blue Shield blue choice percent of total billed charges · outpatientfrom % of charges | $159 | $483 | $1.5k | 306% | — | $1 – $12.3k |
| 12 | Blue Cross Blue Shield blue choice options percent of total billed charges · outpatientfrom % of charges | $159 | $483 | $1.5k | 306% | — | $1 – $12.3k |
| 13 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $161 | $490 | $1.5k | 306% | 80–800 | $1 – $12.5k |
| 14 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $196 | $597 | $1.8k | 306% | — | $2 – $15.3k |
| 15 | Aetna commercial ppo percent of total billed charges · outpatientfrom % of charges | $200 | $607 | $1.9k | 306% | — | $2 – $15.5k |
| 16 | Aetna medicare advantage percent of total billed charges · outpatientfrom % of charges | $204 | $620 | $1.9k | 306% | — | $2 – $15.8k |
| 17 | MultiPlan ppo percent of total billed charges · inpatientfrom % of charges | $204 | $620 | $1.9k | 306% | — | $2 – $15.8k |
| 18 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $204 | $620 | $1.9k | 306% | — | $2 – $15.8k |
| 19 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $273 | $830 | $2.5k | 306% | — | $2 – $21.2k |
Last updated: Apr 15, 2026
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