Comprehensive eye exam for new patient 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

COMPRE OPH EXAM NEW PT 1/>

Maple Grove, MN

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Pricing by billing methodology

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $117 is 19% below the median hospital's median price ($145), higher than 16% of the 1,426 hospitals reporting CPT 92004. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 92004 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 6 payers, 25 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	$65	$65	—	—	—	$65 – $65
2	Ucare mhcp fee schedule · both	$66	$66	—	—	—	$66 – $66
3	Medica accessability fee schedule · both	$69	$69	—	—	—	$69 – $69
4	Medica medicaid fee schedule · both	$69	$69	—	—	—	$69 – $69
5	Blue Cross Blue Shield medicaid fee schedule · both	$74	$74	—	—	—	$74 – $74
6	UnitedHealthcare medicare advantage fee schedule · both	$88	$88	—	—	—	$88 – $88
7	Blue Cross Blue Shield medicare advantage fee schedule · both	$91	$91	—	—	—	$91 – $91
8	Medica ma non-snp fee schedule · both	$94	$94	—	—	—	$94 – $94
9	Medica ma snp fee schedule · both	$94	$94	—	—	—	$94 – $94
10	Medica prime solution fee schedule · both	$94	$94	—	—	—	$94 – $94
11	Medica vantage fee schedule · both	$94	$94	—	—	—	$94 – $94
12	Blue Cross Blue Shield federal fee schedule · outpatient	$117	$117	—	—	—	$117 – $117
13	Blue Cross Blue Shield commercial fee schedule · outpatient	$119	$119	—	—	—	$119 – $119
14	Blue Cross Blue Shield medicaid fee schedule · outpatient	$119	$119	—	—	—	$119 – $119
15	Cigna commercial fee schedule · outpatient	$143	$143	$12	9%	—	$131 – $156
16	Ucare ifp with fairview fee schedule · both	$231	$231	—	—	—	$231 – $231
17	Ucare ifp fee schedule · both	$244	$244	—	—	—	$244 – $244
18	Medica bold fee schedule · both	$256	$256	—	—	—	$256 – $256
19	Medica choice without / elect fee schedule · both	$285	$285	—	—	—	$285 – $285
20	Medica city of st paul / essential uplan fee schedule · both	$285	$285	—	—	—	$285 – $285
21	UnitedHealthcare commercial fee schedule · both	$287	$287	—	—	—	$287 – $287
22	Medica choice with fee schedule · both	$295	$295	—	—	—	$295 – $295
23	Blue Cross Blue Shield federal fee schedule · both	$309	$309	—	—	—	$309 – $309
24	Blue Cross Blue Shield commercial fee schedule · both	$315	$315	—	—	—	$315 – $315
25	Cigna commercial fee schedule · both	$419	$419	$36	9%	—	$383 – $456

Last updated: May 18, 2026

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See Comprehensive eye exam for new patient pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.