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
Spherocylinder 4.25d/4.25-6d
Edina, MN
See all hospitals reporting HCPCS V2109 →Price type
Fairview Health Services’s median price of $103 is 46% above the median hospital's median price ($71), higher than 89% of the 730 hospitals reporting HCPCS V2109. 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, 29 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 | Bcbs Mn pmap fee schedule · outpatient | $36 | $36 | — | — | — | $36 – $36 |
| 2 | Bcbs Mn aware federal fee schedule · both | $74 | $74 | — | — | — | $74 – $74 |
| 3 | Bcbs Mn aware/blue plus fee schedule · both | $75 | $75 | — | — | — | $75 – $75 |
| 4 | Sanford Health Plan medicare advantage fee schedule · outpatient | $78 | $78 | — | — | — | $78 – $78 |
| 5 | UnitedHealthcare medicare advantage fee schedule · outpatient | $78 | $78 | — | — | — | $78 – $78 |
| 6 | WellCare medicare advantage fee schedule · outpatient | $78 | $78 | — | — | — | $78 – $78 |
| 7 | Ucare medicare advantage/msho fee schedule · outpatient | $79 | $79 | — | — | — | $79 – $79 |
| 8 | Bcbs Mn medicare advantage fee schedule · outpatient | $81 | $81 | — | — | — | $81 – $81 |
| 9 | Medica medicare advantage non-snp fee schedule · outpatient | $83 | $83 | — | — | — | $83 – $83 |
| 10 | Medica medicare advantage non-snp fee schedule · both | $84 | $84 | — | — | — | $84 – $84 |
| 11 | Bcbs Mn aware federal fee schedule · outpatient | $85 | $85 | — | — | — | $85 – $85 |
| 12 | Medica msho/medicare advantage snp fee schedule · both | $86 | $86 | — | — | — | $86 – $86 |
| 13 | Bcbs Mn aware/blue plus fee schedule · outpatient | $86 | $86 | — | — | — | $86 – $86 |
| 14 | Medica managed medicaid/accessability fee schedule · outpatient | $95 | $95 | — | — | — | $95 – $95 |
| 15 | Medica msho/medicare advantage snp fee schedule · outpatient | $103 | $103 | — | — | — | $103 – $103 |
| 16 | UnitedHealthcare commercial fee schedule · both | $124 | $124 | — | — | — | $124 – $124 |
| 17 | UnitedHealthcare core fee schedule · both | $124 | $124 | — | — | — | $124 – $124 |
| 18 | Ucare individual and family with m health fairview fee schedule · outpatient | $139 | $139 | — | — | — | $139 – $139 |
| 19 | Medica bold fee schedule · both | $146 | $146 | — | — | — | $146 – $146 |
| 20 | Medica vantage self insured fee schedule · both | $158 | $158 | — | — | — | $158 – $158 |
| 21 | Medica city of st. paul/essential-uplan fee schedule · both | $162 | $162 | — | — | — | $162 – $162 |
| 22 | Medica individual and family business except aco fee schedule · both | $162 | $162 | — | — | — | $162 – $162 |
| 23 | Medica choice fee schedule · both | $168 | $168 | — | — | — | $168 – $168 |
| 24 | Medica bold fee schedule · outpatient | $177 | $177 | — | — | — | $177 – $177 |
| 25 | Ucare individual and family fee schedule · outpatient | $179 | $179 | — | — | — | $179 – $179 |
Last updated: Feb 6, 2026
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