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.
Original text from hospital filings
Inpt/ED teleconsult30
Maple Grove, MN
See all hospitals reporting HCPCS G0425 →Price type
Fairview Maple Grove Surgery Center’s median price of $106 is 6% below the median hospital's median price ($113), higher than 43% of the 781 hospitals reporting HCPCS G0425. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 25 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 | Medicaid medicaid fee schedule · both | $62 | $62 | — | — | — | $62 – $62 |
| 2 | Ucare mhcp fee schedule · both | $63 | $63 | — | — | — | $63 – $63 |
| 3 | Medica accessability fee schedule · both | $67 | $67 | — | — | — | $67 – $67 |
| 4 | Medica medicaid fee schedule · both | $67 | $67 | — | — | — | $67 – $67 |
| 5 | Blue Cross Blue Shield medicaid fee schedule · both | $71 | $71 | — | — | — | $71 – $71 |
| 6 | UnitedHealthcare medicare advantage fee schedule · both | $84 | $84 | — | — | — | $84 – $84 |
| 7 | Blue Cross Blue Shield medicare advantage fee schedule · both | $88 | $88 | — | — | — | $88 – $88 |
| 8 | Medica ma non-snp fee schedule · both | $91 | $91 | — | — | — | $91 – $91 |
| 9 | Medica ma snp fee schedule · both | $91 | $91 | — | — | — | $91 – $91 |
| 10 | Medica prime solution fee schedule · both | $91 | $91 | — | — | — | $91 – $91 |
| 11 | Medica vantage fee schedule · both | $91 | $91 | — | — | — | $91 – $91 |
| 12 | Cigna commercial fee schedule · both | $116 | $116 | $10 | 9% | — | $106 – $126 |
| 13 | Blue Cross Blue Shield federal fee schedule · outpatient | $174 | $174 | — | — | — | $174 – $174 |
| 14 | Blue Cross Blue Shield commercial fee schedule · outpatient | $177 | $177 | — | — | — | $177 – $177 |
| 15 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $177 | $177 | — | — | — | $177 – $177 |
| 16 | Ucare ifp with fairview fee schedule · both | $222 | $222 | — | — | — | $222 – $222 |
| 17 | Ucare ifp fee schedule · both | $234 | $234 | — | — | — | $234 – $234 |
| 18 | Cigna commercial fee schedule · outpatient | $243 | $243 | $21 | 9% | — | $222 – $265 |
| 19 | Medica bold fee schedule · both | $267 | $267 | — | — | — | $267 – $267 |
| 20 | UnitedHealthcare commercial fee schedule · both | $292 | $292 | — | — | — | $292 – $292 |
| 21 | Medica choice without / elect fee schedule · both | $296 | $296 | — | — | — | $296 – $296 |
| 22 | Medica city of st paul / essential uplan fee schedule · both | $296 | $296 | — | — | — | $296 – $296 |
| 23 | Medica choice with fee schedule · both | $307 | $307 | — | — | — | $307 – $307 |
| 24 | Blue Cross Blue Shield federal fee schedule · both | $307 | $307 | — | — | — | $307 – $307 |
| 25 | Blue Cross Blue Shield commercial fee schedule · both | $313 | $313 | — | — | — | $313 – $313 |
Last updated: May 18, 2026
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