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
REMOVE CONTRACEPTIVE CAPSULE
Maple Grove, MN
See all hospitals reporting CPT 11976 →Price type
Fairview Maple Grove Surgery Center’s median price of $228 is 71% below the median hospital's median price ($787), higher than 15% of the 1,815 hospitals reporting CPT 11976. 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, 41 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 | $60.28 | $60.28 | $60.28 – $60.28 |
| 2 | Ucare mhcp fee schedule · both | $61.45 | $61.45 | $61.45 – $61.45 |
| 3 | Medica accessability fee schedule · both | $64.86 | $64.86 | $64.86 – $64.86 |
| 4 | Medica medicaid fee schedule · both | $64.86 | $64.86 | $64.86 – $64.86 |
| 5 | Blue Cross Blue Shield medicaid fee schedule · both | $69.40 | $69.40 | $69.40 – $69.40 |
| 6 | UnitedHealthcare medicare advantage fee schedule · outpatient | $73.96 | $73.96 | $73.96 – $73.96 |
| 7 | Medicaid medicaid fee schedule · outpatient | $74.49 | $74.49 | $74.49 – $74.49 |
| 8 | Blue Cross Blue Shield medicare advantage fee schedule · outpatient | $76.92 | $76.92 | $76.92 – $76.92 |
| 9 | UnitedHealthcare medicare advantage fee schedule · both | $81.94 | $81.94 | $81.94 – $81.94 |
| 10 | Blue Cross Blue Shield medicare advantage fee schedule · both | $85.22 | $85.22 | $85.22 – $85.22 |
| 11 | Ucare mhcp fee schedule · outpatient | $86.62 | $86.62 | $86.62 – $86.62 |
| 12 | Medica ma non-snp fee schedule · both | $88.02 | $88.02 | $88.02 – $88.02 |
| 13 | Medica ma snp fee schedule · both | $88.02 | $88.02 | $88.02 – $88.02 |
| 14 | Medica prime solution fee schedule · both | $88.02 | $88.02 | $88.02 – $88.02 |
| 15 | Medica vantage fee schedule · both | $88.02 | $88.02 | $88.02 – $88.02 |
| 16 | Ucare ifp with fairview fee schedule · outpatient | $127.51 | $127.51 | $127.51 – $127.51 |
| 17 | Ucare ifp fee schedule · outpatient | $169.96 | $169.96 | $169.96 – $169.96 |
| 18 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $192.58 | $192.58 | $192.58 – $192.58 |
| 19 | Ucare ifp with fairview fee schedule · both | $216.24 | $216.24 | $216.24 – $216.24 |
| 20 | Ucare ifp fee schedule · both | $227.79 | $227.79 | $227.79 – $227.79 |
| 21 | Medica bold fee schedule · both | $260.39 | $260.39 | $260.39 – $260.39 |
| 22 | Medica choice without / elect fee schedule · both | $289.32 | $289.32 | $289.32 – $289.32 |
| 23 | Medica city of st paul / essential uplan fee schedule · both | $289.32 | $289.32 | $289.32 – $289.32 |
| 24 | Medica choice with fee schedule · both | $299.42 | $299.42 | $299.42 – $299.42 |
| 25 | UnitedHealthcare commercial fee schedule · both | $307.47 | $307.47 | $307.47 – $307.47 |
Last updated: May 18, 2026
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