Sacroiliac joint injection with imaging guidance 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

HC INJ FOR SACROILIAC JT ANESTH

Maple Grove, MN

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $657 is 40% below the median hospital's median price ($1.1k), higher than 9% of the 1,906 hospitals reporting HCPCS G0260. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS G0260 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 8 payers, 26 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 · outpatient	$92	$92	—	—	—	$92 – $92
2	Blue Cross Blue Shield federal fee schedule · both	$127	$127	—	—	—	$127 – $127
3	Blue Cross Blue Shield commercial fee schedule · both	$129	$129	—	—	—	$129 – $129
4	Blue Cross Blue Shield federal fee schedule · outpatient	$152	$152	—	—	—	$152 – $152
5	Blue Cross Blue Shield commercial fee schedule · outpatient	$154	$154	—	—	—	$154 – $154
6	Cigna commercial fee schedule · both	$174	$174	$15	9%	—	$159 – $189
7	Medica ma non-snp fee schedule · outpatient	$376	$376	—	—	—	$376 – $376
8	UnitedHealthcare medicare advantage fee schedule · outpatient	$376	$376	—	—	—	$376 – $376
9	Medicaid medicaid fee schedule · outpatient	$379	$379	—	—	—	$379 – $379
10	Blue Cross Blue Shield medicare advantage fee schedule · outpatient	$391	$391	—	—	—	$391 – $391
11	Ucare mhcp fee schedule · outpatient	$441	$441	—	—	—	$441 – $441
12	Medica accessability fee schedule · outpatient	$524	$524	—	—	—	$524 – $524
13	Medica medicaid fee schedule · outpatient	$613	$613	—	—	—	$613 – $613
14	Ucare ifp with fairview fee schedule · outpatient	$648	$648	—	—	—	$648 – $648
15	Cigna commercial fee schedule · outpatient	$769	$769	$67	9%	—	$702 – $836
16	Medica ma snp fee schedule · outpatient	$818	$818	—	—	—	$818 – $818
17	Ucare ifp fee schedule · outpatient	$864	$864	—	—	—	$864 – $864
18	First Health commercial percent of total billed charges · outpatientfrom % of charges	$1.3k	$1.3k	$29	2%	—	$1.3k – $1.4k
19	MultiPlan commercial percent of total billed charges · outpatientfrom % of charges	$1.4k	$1.4k	$30	2%	—	$1.3k – $1.4k
20	Medica bold fee schedule · outpatient	$1.4k	$1.4k	—	—	—	$1.4k – $1.4k
21	Medica city of st paul / essential uplan fee schedule · outpatient	$1.5k	$1.5k	—	—	—	$1.5k – $1.5k
22	UnitedHealthcare commercial fee schedule · outpatient	$1.5k	$1.5k	—	—	—	$1.5k – $1.5k
23	Medica vantage fee schedule · outpatient	$1.5k	$1.5k	—	—	—	$1.5k – $1.5k
24	Medica choice without / elect fee schedule · outpatient	$1.6k	$1.6k	—	—	—	$1.6k – $1.6k
25	Medica prime solution fee schedule · outpatient	$1.6k	$1.6k	—	—	—	$1.6k – $1.6k

Page 1 of 2 · 26 rates

Last updated: May 18, 2026

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