Foscarnet sodium injection, per 1000 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.

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Provider: anthropic
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Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

FOSCARNET SODIUM 6000 MG/250ML IV SOLN

Maple Grove, MN

See all hospitals reporting HCPCS J1455 →

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $28 is 53% below the median hospital's median price ($60), higher than 29% of the 1,621 hospitals reporting HCPCS J1455. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J1455 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	Medica accessability fee schedule · both	$3	$3	—	—	—	$3 – $3
2	Medica medicaid fee schedule · both	$3	$3	—	—	—	$3 – $3
3	Blue Cross Blue Shield medicaid fee schedule · both	$4	$4	—	—	—	$4 – $4
4	Cigna commercial fee schedule · both	$4	$4	$0	9%	—	$4 – $5
5	Cigna commercial fee schedule · outpatient	$7	$7	$1	9%	—	$6 – $7
6	Ucare mhcp fee schedule · both	$15	$15	—	—	—	$15 – $15
7	UnitedHealthcare medicare advantage fee schedule · outpatient	$16	$16	—	—	—	$16 – $16
8	Blue Cross Blue Shield medicare advantage fee schedule · outpatient	$16	$16	—	—	—	$16 – $16
9	Medicaid medicaid fee schedule · both	$17	$17	—	—	—	$17 – $17
10	Ucare ifp with fairview fee schedule · outpatient	$27	$27	—	—	—	$27 – $27
11	Ucare ifp fee schedule · outpatient	$36	$36	—	—	—	$36 – $36
12	Medica ma non-snp fee schedule · both	$41	$41	—	—	—	$41 – $41
13	Medica ma snp fee schedule · both	$41	$41	—	—	—	$41 – $41
14	Medica prime solution fee schedule · both	$41	$41	—	—	—	$41 – $41
15	Medica vantage fee schedule · both	$41	$41	—	—	—	$41 – $41
16	Blue Cross Blue Shield federal fee schedule · both	$80	$80	—	—	—	$80 – $80
17	Blue Cross Blue Shield federal fee schedule · outpatient	$81	$81	—	—	—	$81 – $81
18	Blue Cross Blue Shield commercial fee schedule · both	$82	$82	—	—	—	$82 – $82
19	Blue Cross Blue Shield commercial fee schedule · outpatient	$83	$83	—	—	—	$83 – $83
20	Blue Cross Blue Shield medicaid fee schedule · outpatient	$83	$83	—	—	—	$83 – $83
21	UnitedHealthcare commercial fee schedule · both	$119	$119	—	—	—	$119 – $119
22	Medica bold fee schedule · both	$149	$149	—	—	—	$149 – $149
23	Medica choice without / elect fee schedule · both	$165	$165	—	—	—	$165 – $165
24	Medica city of st paul / essential uplan fee schedule · both	$165	$165	—	—	—	$165 – $165
25	Medica choice with fee schedule · both	$171	$171	—	—	—	$171 – $171

Page 1 of 2 · 27 rates

Last updated: May 18, 2026

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