Phentolamine mesylate injection 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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Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PHENTOLAMINE MESYLATE 5 MG IJ SOLR

Maple Grove, MN

See all hospitals reporting HCPCS J2760 →

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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 $573 is 4% above the median hospital's median price ($549), higher than 52% of the 2,076 hospitals reporting HCPCS J2760. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J2760 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	$367	$367	—	—	—	$367 – $367
2	Medica medicaid fee schedule · both	$367	$367	—	—	—	$367 – $367
3	Blue Cross Blue Shield medicaid fee schedule · both	$400	$400	—	—	—	$400 – $400
4	Medica ma non-snp fee schedule · both	$418	$418	—	—	—	$418 – $418
5	Medica ma snp fee schedule · both	$418	$418	—	—	—	$418 – $418
6	Medica prime solution fee schedule · both	$418	$418	—	—	—	$418 – $418
7	Medica vantage fee schedule · both	$418	$418	—	—	—	$418 – $418
8	Ucare mhcp fee schedule · both	$418	$418	—	—	—	$418 – $418
9	UnitedHealthcare medicare advantage fee schedule · outpatient	$425	$425	—	—	—	$425 – $425
10	Blue Cross Blue Shield medicare advantage fee schedule · outpatient	$442	$442	—	—	—	$442 – $442
11	Blue Cross Blue Shield federal fee schedule · both	$447	$447	—	—	—	$447 – $447
12	Blue Cross Blue Shield federal fee schedule · outpatient	$450	$450	—	—	—	$450 – $450
13	Blue Cross Blue Shield commercial fee schedule · both	$455	$455	—	—	—	$455 – $455
14	Blue Cross Blue Shield commercial fee schedule · outpatient	$458	$458	—	—	—	$458 – $458
15	Blue Cross Blue Shield medicaid fee schedule · outpatient	$458	$458	—	—	—	$458 – $458
16	Medicaid medicaid fee schedule · both	$466	$466	—	—	—	$466 – $466
17	Cigna commercial fee schedule · both	$530	$530	$46	9%	—	$484 – $576
18	UnitedHealthcare commercial fee schedule · both	$666	$666	—	—	—	$666 – $666
19	Cigna commercial fee schedule · outpatient	$671	$671	$58	9%	—	$613 – $730
20	Ucare ifp with fairview fee schedule · outpatient	$733	$733	—	—	—	$733 – $733
21	Medica bold fee schedule · both	$842	$842	—	—	—	$842 – $842
22	Medica choice without / elect fee schedule · both	$936	$936	—	—	—	$936 – $936
23	Medica city of st paul / essential uplan fee schedule · both	$936	$936	—	—	—	$936 – $936
24	Medica choice with fee schedule · both	$969	$969	—	—	—	$969 – $969
25	Ucare ifp fee schedule · outpatient	$977	$977	—	—	—	$977 – $977

Page 1 of 2 · 27 rates

Last updated: May 18, 2026

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