Ravulizumab injection (Ultomiris), per 10 mg 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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

RAVULIZUMAB-CWVZ 1100 MG/11ML IV SOLN

Maple Grove, MN

See all hospitals reporting HCPCS J1303 →

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $243 is 33% below the median hospital's median price ($360), higher than 29% of the 1,650 hospitals reporting HCPCS J1303. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J1303 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 8 payers, 27 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	Ucare mhcp fee schedule · both	$209	$209	—	—	—	$209 – $209
2	Medica accessability fee schedule · both	$218	$218	—	—	—	$218 – $218
3	Medica medicaid fee schedule · both	$218	$218	—	—	—	$218 – $218
4	UnitedHealthcare medicare advantage fee schedule · outpatient	$222	$222	—	—	—	$222 – $222
5	Blue Cross Blue Shield federal fee schedule · both	$222	$222	—	—	—	$222 – $222
6	Blue Cross Blue Shield federal fee schedule · outpatient	$223	$223	—	—	—	$223 – $223
7	Blue Cross Blue Shield commercial fee schedule · both	$226	$226	—	—	—	$226 – $226
8	Blue Cross Blue Shield commercial fee schedule · outpatient	$227	$227	—	—	—	$227 – $227
9	Blue Cross Blue Shield medicaid fee schedule · outpatient	$227	$227	—	—	—	$227 – $227
10	Blue Cross Blue Shield medicare advantage fee schedule · outpatient	$230	$230	—	—	—	$230 – $230
11	Blue Cross Blue Shield medicaid fee schedule · both	$232	$232	—	—	—	$232 – $232
12	Medicaid medicaid fee schedule · both	$233	$233	—	—	—	$233 – $233
13	Medica ma non-snp fee schedule · both	$234	$234	—	—	—	$234 – $234
14	Medica ma snp fee schedule · both	$234	$234	—	—	—	$234 – $234
15	Medica prime solution fee schedule · both	$234	$234	—	—	—	$234 – $234
16	Medica vantage fee schedule · both	$234	$234	—	—	—	$234 – $234
17	Cigna commercial fee schedule · both	$265	$265	$23	9%	—	$242 – $288
18	Cigna commercial fee schedule · outpatient	$266	$266	$23	9%	—	$243 – $289
19	Ucare ifp with fairview fee schedule · outpatient	$382	$382	—	—	—	$382 – $382
20	UnitedHealthcare commercial fee schedule · both	$400	$400	—	—	—	$400 – $400
21	Medica bold fee schedule · both	$418	$418	—	—	—	$418 – $418
22	Medica choice without / elect fee schedule · both	$465	$465	—	—	—	$465 – $465
23	Medica city of st paul / essential uplan fee schedule · both	$465	$465	—	—	—	$465 – $465
24	Medica choice with fee schedule · both	$481	$481	—	—	—	$481 – $481
25	Ucare ifp fee schedule · outpatient	$509	$509	—	—	—	$509 – $509

Page 1 of 2 · 27 rates

Last updated: May 18, 2026

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See Ravulizumab injection (Ultomiris), per 10 mg pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.