Levocarnitine injection, per gram 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
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Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

LEVOCARNITINE 200 MG/ML IV SOLN

Maple Grove, MN

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Pricing by billing methodology

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $42 is 23% below the median hospital's median price ($54), higher than 36% of the 1,685 hospitals reporting HCPCS J1955. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J1955 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 8 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	Ucare mhcp fee schedule · both	$23	$23	—	—	—	$23 – $23
2	Medicaid medicaid fee schedule · both	$26	$26	—	—	—	$26 – $26
3	Medica ma non-snp fee schedule · both	$27	$27	—	—	—	$27 – $27
4	Medica ma snp fee schedule · both	$27	$27	—	—	—	$27 – $27
5	Medica prime solution fee schedule · both	$27	$27	—	—	—	$27 – $27
6	Medica vantage fee schedule · both	$27	$27	—	—	—	$27 – $27
7	Medica accessability fee schedule · both	$28	$28	—	—	—	$28 – $28
8	Medica medicaid fee schedule · both	$28	$28	—	—	—	$28 – $28
9	Blue Cross Blue Shield medicaid fee schedule · both	$30	$30	—	—	—	$30 – $30
10	Blue Cross Blue Shield federal fee schedule · outpatient	$30	$30	—	—	—	$30 – $30
11	Blue Cross Blue Shield commercial fee schedule · outpatient	$31	$31	—	—	—	$31 – $31
12	Blue Cross Blue Shield medicaid fee schedule · outpatient	$31	$31	—	—	—	$31 – $31
13	Blue Cross Blue Shield federal fee schedule · both	$35	$35	—	—	—	$35 – $35
14	Blue Cross Blue Shield commercial fee schedule · both	$36	$36	—	—	—	$36 – $36
15	Cigna commercial fee schedule · both	$42	$42	$4	9%	—	$38 – $46
16	UnitedHealthcare commercial fee schedule · both	$50	$50	—	—	—	$50 – $50
17	Cigna commercial fee schedule · outpatient	$51	$51	$4	9%	—	$46 – $55
18	Ucare ifp percent of total billed charges · outpatientfrom % of charges	$68	$66	$24	37%	—	$34 – $94
19	Ucare ifp with fairview percent of total billed charges · outpatientfrom % of charges	$68	$66	$24	37%	—	$34 – $94
20	Medica bold fee schedule · both	$67	$67	—	—	—	$67 – $67
21	Medica choice without / elect fee schedule · both	$74	$74	—	—	—	$74 – $74
22	Medica city of st paul / essential uplan fee schedule · both	$74	$74	—	—	—	$74 – $74
23	Medica choice with fee schedule · both	$77	$77	—	—	—	$77 – $77
24	First Health commercial percent of total billed charges · outpatientfrom % of charges	$112	$108	$40	37%	—	$55 – $154
25	MultiPlan commercial percent of total billed charges · outpatientfrom % of charges	$116	$112	$41	37%	—	$57 – $159

Last updated: May 18, 2026

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