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
FNA BX W/O IMG GDN EA ADDL
Maple Grove, MN
See all hospitals reporting CPT 10004 →Price type
Fairview Maple Grove Surgery Center’s median price of $136 is 71% below the median hospital's median price ($461), higher than 30% of the 1,449 hospitals reporting CPT 10004. 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, 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.
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| # | ||||
|---|---|---|---|---|
| 1 | Medicaid medicaid fee schedule · both | $28.49 | $28.49 | $28.49 – $28.49 |
| 2 | Ucare mhcp fee schedule · both | $29.04 | $29.04 | $29.04 – $29.04 |
| 3 | Medica accessability fee schedule · both | $30.28 | $30.28 | $30.28 – $30.28 |
| 4 | Medica medicaid fee schedule · both | $30.28 | $30.28 | $30.28 – $30.28 |
| 5 | Blue Cross Blue Shield medicaid fee schedule · both | $32.40 | $32.40 | $32.40 – $32.40 |
| 6 | UnitedHealthcare medicare advantage fee schedule · both | $38.78 | $38.78 | $38.78 – $38.78 |
| 7 | Blue Cross Blue Shield medicare advantage fee schedule · both | $40.33 | $40.33 | $40.33 – $40.33 |
| 8 | Medica ma non-snp fee schedule · both | $41.66 | $41.66 | $41.66 – $41.66 |
| 9 | Medica ma snp fee schedule · both | $41.66 | $41.66 | $41.66 – $41.66 |
| 10 | Medica prime solution fee schedule · both | $41.66 | $41.66 | $41.66 – $41.66 |
| 11 | Medica vantage fee schedule · both | $41.66 | $41.66 | $41.66 – $41.66 |
| 12 | Ucare ifp with fairview fee schedule · both | $102.34 | $102.34 | $102.34 – $102.34 |
| 13 | Ucare ifp fee schedule · both | $107.81 | $107.81 | $107.81 – $107.81 |
| 14 | Medica bold fee schedule · both | $122.05 | $122.05 | $122.05 – $122.05 |
| 15 | Medica choice without / elect fee schedule · both | $135.61 | $135.61 | $135.61 – $135.61 |
| 16 | Medica city of st paul / essential uplan fee schedule · both | $135.61 | $135.61 | $135.61 – $135.61 |
| 17 | Medica choice with fee schedule · both | $140.35 | $140.35 | $140.35 – $140.35 |
| 18 | UnitedHealthcare commercial fee schedule · both | $140.78 | $140.78 | $140.78 – $140.78 |
| 19 | Blue Cross Blue Shield federal fee schedule · both | $144.08 | $144.08 | $144.08 – $144.08 |
| 20 | Blue Cross Blue Shield commercial fee schedule · both | $146.67 | $146.67 | $146.67 – $146.67 |
| 21 | Cigna commercial fee schedule · both | $183.75 | $183.75 | $167.77 – $199.73 |
| 22 | Medica accessability fee schedule · outpatient | $220.00 | $220.00 | $220.00 – $220.00 |
| 23 | Medica medicaid fee schedule · outpatient | $256.00 | $256.00 | $256.00 – $256.00 |
| 24 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $276.39 | $276.39 | $276.39 – $276.39 |
| 25 | Medica ma snp fee schedule · outpatient | $341.00 | $341.00 | $341.00 – $341.00 |
Last updated: May 18, 2026
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