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
BONE SRGRY CMPTR FLUOR IMAGE
Maple Grove, MN
See all hospitals reporting CPT 0054T →Price type
Fairview Maple Grove Surgery Center’s median price of $215 is 86% below the median hospital's median price ($1.5k), higher than 19% of the 1,025 hospitals reporting CPT 0054T. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 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 | Blue Cross Blue Shield federal fee schedule · both | $65.28 | $65.28 | $65.28 – $65.28 |
| 2 | Blue Cross Blue Shield federal fee schedule · outpatient | $65.28 | $65.28 | $65.28 – $65.28 |
| 3 | Blue Cross Blue Shield commercial fee schedule · both | $66.46 | $66.46 | $66.46 – $66.46 |
| 4 | Blue Cross Blue Shield commercial fee schedule · outpatient | $66.46 | $66.46 | $66.46 – $66.46 |
| 5 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $66.46 | $66.46 | $66.46 – $66.46 |
| 6 | UnitedHealthcare medicare advantage fee schedule · both | $145.01 | $145.01 | $145.01 – $145.01 |
| 7 | Blue Cross Blue Shield medicare advantage fee schedule · both | $150.81 | $150.81 | $150.81 – $150.81 |
| 8 | Medica ma non-snp fee schedule · both | $164.59 | $164.59 | $164.59 – $164.59 |
| 9 | Medica ma snp fee schedule · both | $164.59 | $164.59 | $164.59 – $164.59 |
| 10 | Medica prime solution fee schedule · both | $164.59 | $164.59 | $164.59 – $164.59 |
| 11 | Medica vantage fee schedule · both | $164.59 | $164.59 | $164.59 – $164.59 |
| 12 | Cigna commercial fee schedule · both | $197.56 | $197.56 | $180.38 – $214.74 |
| 13 | Medica accessability fee schedule · outpatient | $220.00 | $220.00 | $220.00 – $220.00 |
| 14 | Medica medicaid fee schedule · outpatient | $256.00 | $256.00 | $256.00 – $256.00 |
| 15 | Medica bold fee schedule · both | $296.48 | $296.48 | $296.48 – $296.48 |
| 16 | Medica choice without / elect fee schedule · both | $329.42 | $329.42 | $329.42 – $329.42 |
| 17 | Medica city of st paul / essential uplan fee schedule · both | $329.42 | $329.42 | $329.42 – $329.42 |
| 18 | Medica choice with fee schedule · both | $340.90 | $340.90 | $340.90 – $340.90 |
| 19 | Medica ma snp fee schedule · outpatient | $341.00 | $341.00 | $341.00 – $341.00 |
| 20 | Ucare ifp with fairview fee schedule · both | $382.68 | $382.68 | $382.68 – $382.68 |
| 21 | Ucare ifp fee schedule · both | $403.13 | $403.13 | $403.13 – $403.13 |
| 22 | UnitedHealthcare commercial fee schedule · both | $515.85 | $515.85 | $515.85 – $515.85 |
| 23 | Medica bold fee schedule · outpatient | $590.00 | $590.00 | $590.00 – $590.00 |
| 24 | Medica city of st paul / essential uplan fee schedule · outpatient | $610.00 | $610.00 | $610.00 – $610.00 |
| 25 | UnitedHealthcare commercial fee schedule · outpatient | $625.00 | $625.00 | $625.00 – $625.00 |
Last updated: May 18, 2026
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