Wheelchair back cushion with lateral supports 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

WC planar back cush wd <22in

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 $482 is 1% above the median hospital's median price ($475), higher than 57% of the 607 hospitals reporting HCPCS E2620. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS E2620 at Fairview Maple Grove Surgery Center

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 medicaid fee schedule · both	$264	$264	$216	82%	—	$48 – $481
2	Ucare mhcp fee schedule · both	$272	$272	$223	82%	—	$50 – $495
3	Blue Cross Blue Shield commercial fee schedule · both	$293	$293	$240	82%	—	$53 – $533
4	Blue Cross Blue Shield federal fee schedule · both	$293	$293	$240	82%	—	$53 – $533
5	Medica ma non-snp fee schedule · both	$482	$337	$204	61%	—	$48 – $482
6	Medica ma snp fee schedule · both	$482	$337	$204	61%	—	$48 – $482
7	Medica prime solution fee schedule · both	$482	$337	$204	61%	—	$48 – $482
8	Medica vantage fee schedule · both	$482	$337	$204	61%	—	$48 – $482
9	Cigna commercial fee schedule · both	$443	$365	$227	62%	—	$54 – $643
10	Medica accessability fee schedule · both	$441	$441	—	—	—	$441 – $441
11	Medica medicaid fee schedule · both	$441	$441	—	—	—	$441 – $441
12	Blue Cross Blue Shield federal fee schedule · outpatient	$491	$491	—	—	—	$491 – $491
13	Blue Cross Blue Shield commercial fee schedule · outpatient	$500	$500	—	—	—	$500 – $500
14	Blue Cross Blue Shield medicaid fee schedule · outpatient	$500	$500	—	—	—	$500 – $500
15	Medica bold fee schedule · both	$832	$582	$353	61%	—	$83 – $832
16	Ucare ifp with fairview fee schedule · outpatient	$704	$606	$394	65%	—	$80 – $1.2k
17	Medica choice without / elect fee schedule · both	$924	$647	$392	61%	—	$92 – $924
18	Medica city of st paul / essential uplan fee schedule · both	$924	$647	$392	61%	—	$92 – $924
19	Medica choice with fee schedule · both	$956	$670	$406	61%	—	$96 – $956
20	UnitedHealthcare commercial fee schedule · both	$884	$719	$372	52%	—	$101 – $1.0k
21	Ucare ifp fee schedule · outpatient	$938	$807	$525	65%	—	$107 – $1.5k
22	Cigna commercial fee schedule · outpatient	$1.2k	$1.2k	$108	9%	—	$1.1k – $1.3k

Last updated: May 18, 2026

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