Remote evaluation of established patient, 40 minutes 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

Remote E/M est. pt 40mins

Maple Grove, MN

See all hospitals reporting HCPCS G9489 →

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Pricing by billing methodology

Price type

How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $139 is 41% above the median hospital's median price ($98), higher than 65% of the 519 hospitals reporting HCPCS G9489. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS G9489 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 5 payers, 20 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	UnitedHealthcare medicare advantage fee schedule · both	$69	$69	—	—	—	$69 – $69
2	Blue Cross Blue Shield medicare advantage fee schedule · both	$72	$72	—	—	—	$72 – $72
3	Medica ma non-snp fee schedule · both	$74	$74	—	—	—	$74 – $74
4	Medica ma snp fee schedule · both	$74	$74	—	—	—	$74 – $74
5	Medica prime solution fee schedule · both	$74	$74	—	—	—	$74 – $74
6	Medica vantage fee schedule · both	$74	$74	—	—	—	$74 – $74
7	Cigna commercial fee schedule · both	$96	$96	$8	9%	—	$87 – $104
8	Blue Cross Blue Shield federal fee schedule · outpatient	$139	$139	—	—	—	$139 – $139
9	Blue Cross Blue Shield commercial fee schedule · outpatient	$141	$141	—	—	—	$141 – $141
10	Blue Cross Blue Shield medicaid fee schedule · outpatient	$141	$141	—	—	—	$141 – $141
11	Ucare ifp with fairview fee schedule · both	$183	$183	—	—	—	$183 – $183
12	Ucare ifp fee schedule · both	$192	$192	—	—	—	$192 – $192
13	Cigna commercial fee schedule · outpatient	$201	$201	$17	9%	—	$184 – $218
14	Medica bold fee schedule · both	$220	$220	—	—	—	$220 – $220
15	UnitedHealthcare commercial fee schedule · both	$239	$239	—	—	—	$239 – $239
16	Medica choice without / elect fee schedule · both	$244	$244	—	—	—	$244 – $244
17	Medica city of st paul / essential uplan fee schedule · both	$244	$244	—	—	—	$244 – $244
18	Medica choice with fee schedule · both	$253	$253	—	—	—	$253 – $253
19	Blue Cross Blue Shield federal fee schedule · both	$260	$260	—	—	—	$260 – $260
20	Blue Cross Blue Shield commercial fee schedule · both	$265	$265	—	—	—	$265 – $265

Last updated: May 18, 2026

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