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
RIBOFLAV5 & RIBOFLAV5-DEXTRAN 0.146 &0.146-20 % OP SOSY
Edina, MN
See all hospitals reporting HCPCS J2787 →Price type
Fairview Health Services’s median price of $3.8k is 7% below the median hospital's median price ($4.1k), higher than 47% of the 929 hospitals reporting HCPCS J2787. 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, 34 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Bcbs Mn pmap fee schedule · outpatient | $590 | $590 | — | — | — | $590 – $590 |
| 2 | Bcbs Mn aware federal fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 3 | Bcbs Mn aware/blue plus fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 4 | Bcbs Mn aware federal fee schedule · both | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 5 | Bcbs Mn aware/blue plus fee schedule · both | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 6 | Ucare pmap fee schedule · both | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 7 | Medica medicare advantage non-snp fee schedule · both | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 8 | Medica msho/medicare advantage snp fee schedule · both | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 9 | Medica managed medicaid/accessability fee schedule · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 10 | UnitedHealthcare commercial percent of total billed charges · inpatientfrom % of charges | $3.6k | $2.4k | $1.7k | 71% | — | $0 – $3.7k |
| 11 | UnitedHealthcare core percent of total billed charges · inpatientfrom % of charges | $3.6k | $2.4k | $1.7k | 71% | — | $0 – $3.7k |
| 12 | Medica msho/medicare advantage snp fee schedule · outpatient | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 13 | UnitedHealthcare commercial fee schedule · both | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 14 | UnitedHealthcare core fee schedule · both | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 15 | Ucare individual and family percent of total billed charges · outpatientfrom % of charges | $4.5k | $3.0k | $2.1k | 71% | — | $0 – $4.6k |
| 16 | Ucare individual and family with m health fairview percent of total billed charges · outpatientfrom % of charges | $4.5k | $3.0k | $2.1k | 71% | — | $0 – $4.6k |
| 17 | UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges | $4.5k | $3.0k | $2.1k | 71% | — | $0 – $4.6k |
| 18 | UnitedHealthcare core percent of total billed charges · outpatientfrom % of charges | $4.5k | $3.0k | $2.1k | 71% | — | $0 – $4.6k |
| 19 | Sanford Health Plan commercial percent of total billed charges · inpatientfrom % of charges | $5.3k | $3.6k | $2.5k | 71% | — | $0 – $5.5k |
| 20 | Sanford Health Plan commercial percent of total billed charges · outpatientfrom % of charges | $5.3k | $3.6k | $2.5k | 71% | — | $0 – $5.5k |
| 21 | Medica bold fee schedule · both | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 22 | Medica vantage self insured fee schedule · both | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 23 | Medica city of st. paul/essential-uplan fee schedule · both | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 24 | Medica individual and family business except aco fee schedule · both | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 25 | Medica choice fee schedule · both | $4.2k | $4.2k | — | — | — | $4.2k – $4.2k |
Last updated: Feb 6, 2026
See Riboflavin eye drop solution pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.