Custom gradient compression arm sleeve and glove 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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Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Custom gradient sleev/glov

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 $355 is 10% above the median hospital's median price ($323), higher than 81% of the 767 hospitals reporting HCPCS A6574. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A6574 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 5 payers, 19 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 · both	$286	$286	—	—	—	$286 – $286
2	Blue Cross Blue Shield commercial fee schedule · both	$291	$291	—	—	—	$291 – $291
3	Medica accessability fee schedule · both	$301	$301	—	—	—	$301 – $301
4	Medica medicaid fee schedule · both	$301	$301	—	—	—	$301 – $301
5	Blue Cross Blue Shield medicaid fee schedule · both	$327	$327	—	—	—	$327 – $327
6	Medica ma non-snp fee schedule · both	$328	$328	—	—	—	$328 – $328
7	Medica ma snp fee schedule · both	$328	$328	—	—	—	$328 – $328
8	Medica prime solution fee schedule · both	$328	$328	—	—	—	$328 – $328
9	Medica vantage fee schedule · both	$328	$328	—	—	—	$328 – $328
10	Ucare mhcp fee schedule · both	$337	$337	—	—	—	$337 – $337
11	Cigna commercial fee schedule · both	$403	$403	$35	9%	—	$368 – $438
12	Ucare ifp with fairview fee schedule · outpatient	$548	$548	—	—	—	$548 – $548
13	Medica bold fee schedule · both	$567	$567	—	—	—	$567 – $567
14	Medica choice without / elect fee schedule · both	$630	$630	—	—	—	$630 – $630
15	Medica city of st paul / essential uplan fee schedule · both	$630	$630	—	—	—	$630 – $630
16	Medica choice with fee schedule · both	$652	$652	—	—	—	$652 – $652
17	Ucare ifp fee schedule · outpatient	$731	$731	—	—	—	$731 – $731
18	UnitedHealthcare commercial fee schedule · both	$774	$774	—	—	—	$774 – $774
19	Cigna commercial fee schedule · outpatient	$846	$846	$74	9%	—	$773 – $920

Last updated: May 18, 2026

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