Urinary ostomy pouch with extended-wear barrier, convex (one-piece) 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
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Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Urine pch w ex wear bar conv

Maple Grove, MN

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Pricing by billing methodology

Price type

How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $14 is 4% above the median hospital's median price ($13), higher than 66% of the 681 hospitals reporting HCPCS A4393. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A4393 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 5 payers, 21 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	$11	$11	—	—	—	$11 – $11
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$11	$11	—	—	—	$11 – $11
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$11	$11	—	—	—	$11 – $11
4	Blue Cross Blue Shield federal fee schedule · both	$12	$12	—	—	—	$12 – $12
5	Blue Cross Blue Shield commercial fee schedule · both	$12	$12	—	—	—	$12 – $12
6	Medica accessability fee schedule · both	$12	$12	—	—	—	$12 – $12
7	Medica medicaid fee schedule · both	$12	$12	—	—	—	$12 – $12
8	Medica ma non-snp fee schedule · both	$13	$13	—	—	—	$13 – $13
9	Medica ma snp fee schedule · both	$13	$13	—	—	—	$13 – $13
10	Medica prime solution fee schedule · both	$13	$13	—	—	—	$13 – $13
11	Medica vantage fee schedule · both	$13	$13	—	—	—	$13 – $13
12	Blue Cross Blue Shield medicaid fee schedule · both	$13	$13	—	—	—	$13 – $13
13	Ucare mhcp fee schedule · both	$14	$14	—	—	—	$14 – $14
14	Cigna commercial fee schedule · both	$17	$17	$1	9%	—	$15 – $18
15	Ucare ifp with fairview fee schedule · outpatient	$22	$22	—	—	—	$22 – $22
16	UnitedHealthcare commercial fee schedule · both	$23	$23	—	—	—	$23 – $23
17	Medica bold fee schedule · both	$23	$23	—	—	—	$23 – $23
18	Medica choice without / elect fee schedule · both	$26	$26	—	—	—	$26 – $26
19	Medica city of st paul / essential uplan fee schedule · both	$26	$26	—	—	—	$26 – $26
20	Medica choice with fee schedule · both	$27	$27	—	—	—	$27 – $27
21	Ucare ifp fee schedule · outpatient	$30	$30	—	—	—	$30 – $30

Last updated: May 18, 2026

Compare to other hospitals

See Urinary ostomy pouch with extended-wear barrier, convex (one-piece) pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.