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
Non-adju cgm supply allow
Maple Grove, MN
See all hospitals reporting HCPCS A4239 →Price type
Fairview Maple Grove Surgery Center’s median price of $343 is 23% above the median hospital's median price ($279), higher than 79% of the 670 hospitals reporting HCPCS A4239. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 22 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 | Blue Cross Blue Shield federal fee schedule · outpatient | $230 | $230 | — | — | — | $230 – $230 |
| 2 | Blue Cross Blue Shield commercial fee schedule · outpatient | $234 | $234 | — | — | — | $234 – $234 |
| 3 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $234 | $234 | — | — | — | $234 – $234 |
| 4 | Blue Cross Blue Shield federal fee schedule · both | $249 | $249 | — | — | — | $249 – $249 |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $253 | $253 | — | — | — | $253 – $253 |
| 6 | Medica accessability fee schedule · both | $262 | $262 | — | — | — | $262 – $262 |
| 7 | Medica medicaid fee schedule · both | $262 | $262 | — | — | — | $262 – $262 |
| 8 | Medica ma non-snp fee schedule · both | $284 | $284 | — | — | — | $284 – $284 |
| 9 | Medica ma snp fee schedule · both | $284 | $284 | — | — | — | $284 – $284 |
| 10 | Medica prime solution fee schedule · both | $284 | $284 | — | — | — | $284 – $284 |
| 11 | Medica vantage fee schedule · both | $284 | $284 | — | — | — | $284 – $284 |
| 12 | Blue Cross Blue Shield medicaid fee schedule · both | $285 | $285 | — | — | — | $285 – $285 |
| 13 | Ucare mhcp fee schedule · both | $292 | $292 | — | — | — | $292 – $292 |
| 14 | Cigna commercial fee schedule · both | $377 | $380 | $44 | 12% | — | $320 – $444 |
| 15 | Medica bold fee schedule · both | $493 | $493 | — | — | — | $493 – $493 |
| 16 | Ucare ifp with fairview fee schedule · outpatient | $510 | $510 | $39 | 8% | — | $471 – $548 |
| 17 | Medica choice without / elect fee schedule · both | $548 | $548 | — | — | — | $548 – $548 |
| 18 | Medica city of st paul / essential uplan fee schedule · both | $548 | $548 | — | — | — | $548 – $548 |
| 19 | Medica choice with fee schedule · both | $567 | $567 | — | — | — | $567 – $567 |
| 20 | UnitedHealthcare commercial fee schedule · both | $649 | $649 | — | — | — | $649 – $649 |
| 21 | Ucare ifp fee schedule · outpatient | $679 | $679 | $51 | 8% | — | $628 – $731 |
| 22 | Cigna commercial fee schedule · outpatient | $737 | $737 | $64 | 9% | — | $673 – $801 |
Last updated: May 18, 2026
See Continuous glucose monitor supplies, one month pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.