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
CMMI asyntelehealth 10-20min
Maple Grove, MN
See all hospitals reporting HCPCS G9869 →Price type
Fairview Maple Grove Surgery Center’s median price of $65 is 63% above the median hospital's median price ($40), higher than 79% of the 504 hospitals reporting HCPCS G9869. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
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 | $34 | $34 | — | — | — | $34 – $34 |
| 2 | Blue Cross Blue Shield medicare advantage fee schedule · both | $35 | $35 | — | — | — | $35 – $35 |
| 3 | Medica ma non-snp fee schedule · both | $37 | $37 | — | — | — | $37 – $37 |
| 4 | Medica ma snp fee schedule · both | $37 | $37 | — | — | — | $37 – $37 |
| 5 | Medica prime solution fee schedule · both | $37 | $37 | — | — | — | $37 – $37 |
| 6 | Medica vantage fee schedule · both | $37 | $37 | — | — | — | $37 – $37 |
| 7 | Cigna commercial fee schedule · both | $47 | $47 | $4 | 9% | — | $43 – $51 |
| 8 | Blue Cross Blue Shield federal fee schedule · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 9 | Blue Cross Blue Shield commercial fee schedule · outpatient | $65 | $65 | — | — | — | $65 – $65 |
| 10 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $65 | $65 | — | — | — | $65 – $65 |
| 11 | Ucare ifp with fairview fee schedule · both | $90 | $90 | — | — | — | $90 – $90 |
| 12 | Ucare ifp fee schedule · both | $95 | $95 | — | — | — | $95 – $95 |
| 13 | Cigna commercial fee schedule · outpatient | $99 | $99 | $9 | 9% | — | $90 – $107 |
| 14 | Medica bold fee schedule · both | $108 | $108 | — | — | — | $108 – $108 |
| 15 | UnitedHealthcare commercial fee schedule · both | $111 | $111 | — | — | — | $111 – $111 |
| 16 | Blue Cross Blue Shield federal fee schedule · both | $120 | $120 | — | — | — | $120 – $120 |
| 17 | Medica choice without / elect fee schedule · both | $120 | $120 | — | — | — | $120 – $120 |
| 18 | Medica city of st paul / essential uplan fee schedule · both | $120 | $120 | — | — | — | $120 – $120 |
| 19 | Blue Cross Blue Shield commercial fee schedule · both | $122 | $122 | — | — | — | $122 – $122 |
| 20 | Medica choice with fee schedule · both | $124 | $124 | — | — | — | $124 – $124 |
Last updated: May 18, 2026
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