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 CT/MRI IMAG
Maple Grove, MN
See all hospitals reporting CPT 0055T →Price type
Fairview Maple Grove Surgery Center’s median price of $215 is 86% below the median hospital's median price ($1.6k), higher than 14% of the 1,101 hospitals reporting CPT 0055T. 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 | UnitedHealthcare medicare advantage fee schedule · both | $145.01 | $145.01 | $145.01 – $145.01 |
| 2 | Blue Cross Blue Shield medicare advantage fee schedule · both | $150.81 | $150.81 | $150.81 – $150.81 |
| 3 | Blue Cross Blue Shield federal fee schedule · both | $174.24 | $174.24 | $174.24 – $174.24 |
| 4 | Blue Cross Blue Shield federal fee schedule · outpatient | $174.24 | $174.24 | $174.24 – $174.24 |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $177.38 | $177.38 | $177.38 – $177.38 |
| 6 | Blue Cross Blue Shield commercial fee schedule · outpatient | $177.38 | $177.38 | $177.38 – $177.38 |
| 7 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $177.38 | $177.38 | $177.38 – $177.38 |
| 8 | Cigna commercial fee schedule · both | $197.56 | $197.56 | $180.38 – $214.74 |
| 9 | Medica ma non-snp fee schedule · both | $205.75 | $205.75 | $205.75 – $205.75 |
| 10 | Medica ma snp fee schedule · both | $205.75 | $205.75 | $205.75 – $205.75 |
| 11 | Medica prime solution fee schedule · both | $205.75 | $205.75 | $205.75 – $205.75 |
| 12 | Medica vantage fee schedule · both | $205.75 | $205.75 | $205.75 – $205.75 |
| 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 ma snp fee schedule · outpatient | $341.00 | $341.00 | $341.00 – $341.00 |
| 16 | Medica bold fee schedule · both | $370.56 | $370.56 | $370.56 – $370.56 |
| 17 | Ucare ifp with fairview fee schedule · both | $382.68 | $382.68 | $382.68 – $382.68 |
| 18 | Ucare ifp fee schedule · both | $403.13 | $403.13 | $403.13 – $403.13 |
| 19 | Medica choice without / elect fee schedule · both | $411.73 | $411.73 | $411.73 – $411.73 |
| 20 | Medica city of st paul / essential uplan fee schedule · both | $411.73 | $411.73 | $411.73 – $411.73 |
| 21 | Medica choice with fee schedule · both | $426.08 | $426.08 | $426.08 – $426.08 |
| 22 | UnitedHealthcare commercial fee schedule · both | $578.93 | $578.93 | $578.93 – $578.93 |
| 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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