Wheelchair with fixed arms and elevating leg rests 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

Wheelchair spec size w/ leg

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 $843 is 770% above the median hospital's median price ($97), higher than 90% of the 569 hospitals reporting HCPCS E1222. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS E1222 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 5 payers, 18 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	Ucare ifp with fairview fee schedule · outpatient	$162	$162	—	—	—	$162 – $162
2	Ucare ifp fee schedule · outpatient	$216	$216	—	—	—	$216 – $216
3	Blue Cross Blue Shield commercial fee schedule · both	$494	$494	$405	82%	—	$90 – $899
4	Blue Cross Blue Shield federal fee schedule · both	$494	$494	$405	82%	—	$90 – $899
5	Medica ma non-snp fee schedule · both	$843	$595	$352	59%	—	$98 – $843
6	Medica ma snp fee schedule · both	$843	$595	$352	59%	—	$98 – $843
7	Medica prime solution fee schedule · both	$843	$595	$352	59%	—	$98 – $843
8	Medica vantage fee schedule · both	$843	$595	$352	59%	—	$98 – $843
9	Cigna commercial fee schedule · both	$906	$745	$464	62%	—	$110 – $1.3k
10	Blue Cross Blue Shield federal fee schedule · outpatient	$830	$830	—	—	—	$830 – $830
11	Medica bold fee schedule · both	$1.2k	$833	$469	56%	—	$170 – $1.2k
12	Blue Cross Blue Shield commercial fee schedule · outpatient	$845	$845	—	—	—	$845 – $845
13	Blue Cross Blue Shield medicaid fee schedule · outpatient	$845	$845	—	—	—	$845 – $845
14	Medica choice without / elect fee schedule · both	$1.3k	$925	$521	56%	—	$189 – $1.3k
15	Medica city of st paul / essential uplan fee schedule · both	$1.3k	$925	$521	56%	—	$189 – $1.3k
16	Medica choice with fee schedule · both	$1.3k	$958	$539	56%	—	$195 – $1.3k
17	UnitedHealthcare commercial fee schedule · both	$1.5k	$1.2k	$629	52%	—	$172 – $1.7k
18	Cigna commercial fee schedule · outpatient	$2.5k	$2.5k	$220	9%	—	$2.3k – $2.8k

Last updated: May 18, 2026

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