Prostate injection of biodegradable material with image guidance at Fairview Maple Grove Surgery Center

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX

Maple Grove, MN

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $2.5k is 55% below the median hospital's median price ($5.6k), higher than 11% of the 1,805 hospitals reporting CPT 55874. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 55874 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 8 payers, 43 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	$111	$111	—	—	—	$111 – $111
2	Ucare mhcp fee schedule · both	$113	$113	—	—	—	$113 – $113
3	Medica accessability fee schedule · both	$118	$118	—	—	—	$118 – $118
4	Medica medicaid fee schedule · both	$118	$118	—	—	—	$118 – $118
5	Blue Cross Blue Shield medicaid fee schedule · both	$126	$126	—	—	—	$126 – $126
6	UnitedHealthcare medicare advantage fee schedule · both	$151	$151	—	—	—	$151 – $151
7	Blue Cross Blue Shield medicare advantage fee schedule · both	$157	$157	—	—	—	$157 – $157
8	Medica ma non-snp fee schedule · both	$162	$162	—	—	—	$162 – $162
9	Medica ma snp fee schedule · both	$162	$162	—	—	—	$162 – $162
10	Medica prime solution fee schedule · both	$162	$162	—	—	—	$162 – $162
11	Medica vantage fee schedule · both	$162	$162	—	—	—	$162 – $162
12	Ucare ifp with fairview fee schedule · both	$398	$398	—	—	—	$398 – $398
13	Ucare ifp fee schedule · both	$419	$419	—	—	—	$419 – $419
14	Medica bold fee schedule · both	$473	$473	—	—	—	$473 – $473
15	Medica choice without / elect fee schedule · both	$526	$526	—	—	—	$526 – $526
16	Medica city of st paul / essential uplan fee schedule · both	$526	$526	—	—	—	$526 – $526
17	UnitedHealthcare commercial fee schedule · both	$537	$537	—	—	—	$537 – $537
18	Blue Cross Blue Shield federal fee schedule · both	$544	$544	—	—	—	$544 – $544
19	Medica choice with fee schedule · both	$544	$544	—	—	—	$544 – $544
20	Blue Cross Blue Shield commercial fee schedule · both	$554	$554	—	—	—	$554 – $554
21	Cigna commercial fee schedule · both	$712	$712	$62	9%	—	$650 – $774
22	Medica accessability fee schedule · outpatient	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k
23	Medica medicaid fee schedule · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
24	Medica ma snp fee schedule · outpatient	$2.6k	$2.6k	—	—	—	$2.6k – $2.6k
25	Blue Cross Blue Shield medicaid fee schedule · outpatient	$2.9k	$2.9k	—	—	—	$2.9k – $2.9k

Page 1 of 2 · 43 rates

Last updated: May 18, 2026

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