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
HAIR TRNSPL 1-15 PUNCH GRFTS
Maple Grove, MN
See all hospitals reporting CPT 15775 →Price type
Fairview Maple Grove Surgery Center’s median price of $269 is 49% below the median hospital's median price ($523), higher than 5% of the 1,465 hospitals reporting CPT 15775. 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 | $171 | $171 | — | — | — | $171 – $171 |
| 2 | Ucare mhcp fee schedule · both | $174 | $174 | — | — | — | $174 – $174 |
| 3 | Medica accessability fee schedule · both | $181 | $181 | — | — | — | $181 – $181 |
| 4 | Medica medicaid fee schedule · both | $181 | $181 | — | — | — | $181 – $181 |
| 5 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $193 | $193 | — | — | — | $193 – $193 |
| 6 | Blue Cross Blue Shield medicaid fee schedule · both | $194 | $194 | — | — | — | $194 – $194 |
| 7 | UnitedHealthcare medicare advantage fee schedule · outpatient | $217 | $217 | — | — | — | $217 – $217 |
| 8 | Medicaid medicaid fee schedule · outpatient | $218 | $218 | — | — | — | $218 – $218 |
| 9 | Medica accessability fee schedule · outpatient | $220 | $220 | — | — | — | $220 – $220 |
| 10 | Blue Cross Blue Shield medicare advantage fee schedule · outpatient | $226 | $226 | — | — | — | $226 – $226 |
| 11 | UnitedHealthcare medicare advantage fee schedule · both | $231 | $231 | — | — | — | $231 – $231 |
| 12 | Blue Cross Blue Shield medicare advantage fee schedule · both | $240 | $240 | — | — | — | $240 – $240 |
| 13 | Medica ma non-snp fee schedule · both | $248 | $248 | — | — | — | $248 – $248 |
| 14 | Medica ma snp fee schedule · both | $248 | $248 | — | — | — | $248 – $248 |
| 15 | Medica prime solution fee schedule · both | $248 | $248 | — | — | — | $248 – $248 |
| 16 | Medica vantage fee schedule · both | $248 | $248 | — | — | — | $248 – $248 |
| 17 | Ucare mhcp fee schedule · outpatient | $254 | $254 | — | — | — | $254 – $254 |
| 18 | Medica medicaid fee schedule · outpatient | $256 | $256 | — | — | — | $256 – $256 |
| 19 | Blue Cross Blue Shield federal fee schedule · outpatient | $318 | $318 | — | — | — | $318 – $318 |
| 20 | Blue Cross Blue Shield commercial fee schedule · outpatient | $324 | $324 | — | — | — | $324 – $324 |
| 21 | Medica ma snp fee schedule · outpatient | $341 | $341 | — | — | — | $341 – $341 |
| 22 | Ucare ifp with fairview fee schedule · outpatient | $374 | $374 | — | — | — | $374 – $374 |
| 23 | Cigna commercial fee schedule · outpatient | $444 | $444 | $39 | 9% | — | $405 – $482 |
| 24 | Ucare ifp fee schedule · outpatient | $498 | $498 | — | — | — | $498 – $498 |
| 25 | Medica bold fee schedule · outpatient | $590 | $590 | — | — | — | $590 – $590 |
Last updated: May 18, 2026
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