Urinary ostomy pouch with barrier and faucet valve 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

Urine ost pouch w bltinconv

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 $12 is 4% above the median hospital's median price ($12), higher than 65% of the 668 hospitals reporting HCPCS A4429. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A4429 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	$10	$10	—	—	—	$10 – $10
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$10	$10	—	—	—	$10 – $10
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$10	$10	—	—	—	$10 – $10
4	Blue Cross Blue Shield federal fee schedule · both	$11	$11	—	—	—	$11 – $11
5	Blue Cross Blue Shield commercial fee schedule · both	$11	$11	—	—	—	$11 – $11
6	Medica accessability fee schedule · both	$11	$11	—	—	—	$11 – $11
7	Medica medicaid fee schedule · both	$11	$11	—	—	—	$11 – $11
8	Medica ma non-snp fee schedule · both	$12	$12	—	—	—	$12 – $12
9	Medica ma snp fee schedule · both	$12	$12	—	—	—	$12 – $12
10	Medica prime solution fee schedule · both	$12	$12	—	—	—	$12 – $12
11	Medica vantage fee schedule · both	$12	$12	—	—	—	$12 – $12
12	Blue Cross Blue Shield medicaid fee schedule · both	$12	$12	—	—	—	$12 – $12
13	Ucare mhcp fee schedule · both	$13	$13	—	—	—	$13 – $13
14	Cigna commercial fee schedule · both	$15	$15	$1	9%	—	$14 – $16
15	Ucare ifp with fairview fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
16	UnitedHealthcare commercial fee schedule · both	$21	$21	—	—	—	$21 – $21
17	Medica bold fee schedule · both	$21	$21	—	—	—	$21 – $21
18	Medica choice without / elect fee schedule · both	$24	$24	—	—	—	$24 – $24
19	Medica city of st paul / essential uplan fee schedule · both	$24	$24	—	—	—	$24 – $24
20	Medica choice with fee schedule · both	$24	$24	—	—	—	$24 – $24
21	Ucare ifp fee schedule · outpatient	$27	$27	—	—	—	$27 – $27

Last updated: May 18, 2026

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