Trimethobenzamide 200 mg 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.

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

TRIMETHOBENZAMIDE HCL 100 MG/ML IM SOLN

Maple Grove, MN

See all hospitals reporting HCPCS J3250 →

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $60 is 28% below the median hospital's median price ($83), higher than 33% of the 1,530 hospitals reporting HCPCS J3250. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J3250 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 8 payers, 24 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	Blue Cross Blue Shield federal fee schedule · outpatient	$43	$43	—	—	—	$43 – $43
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$44	$44	—	—	—	$44 – $44
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$44	$44	—	—	—	$44 – $44
4	Blue Cross Blue Shield federal fee schedule · both	$48	$48	—	—	—	$48 – $48
5	Blue Cross Blue Shield commercial fee schedule · both	$49	$49	—	—	—	$49 – $49
6	Ucare mhcp fee schedule · both	$51	$51	—	—	—	$51 – $51
7	Medica accessability fee schedule · both	$51	$51	—	—	—	$51 – $51
8	Medica medicaid fee schedule · both	$51	$51	—	—	—	$51 – $51
9	Medica ma non-snp fee schedule · both	$54	$54	—	—	—	$54 – $54
10	Medica ma snp fee schedule · both	$54	$54	—	—	—	$54 – $54
11	Medica prime solution fee schedule · both	$54	$54	—	—	—	$54 – $54
12	Medica vantage fee schedule · both	$54	$54	—	—	—	$54 – $54
13	Blue Cross Blue Shield medicaid fee schedule · both	$56	$56	—	—	—	$56 – $56
14	Medicaid medicaid fee schedule · both	$57	$57	—	—	—	$57 – $57
15	Cigna commercial fee schedule · both	$58	$58	$5	9%	—	$53 – $63
16	Medica bold fee schedule · both	$90	$90	—	—	—	$90 – $90
17	UnitedHealthcare commercial fee schedule · both	$93	$93	—	—	—	$93 – $93
18	Medica choice without / elect fee schedule · both	$100	$100	—	—	—	$100 – $100
19	Medica city of st paul / essential uplan fee schedule · both	$100	$100	—	—	—	$100 – $100
20	Medica choice with fee schedule · both	$104	$104	—	—	—	$104 – $104
21	Ucare ifp percent of total billed charges · outpatientfrom % of charges	$128	$128	—	—	—	$128 – $128
22	Ucare ifp with fairview percent of total billed charges · outpatientfrom % of charges	$128	$128	—	—	—	$128 – $128
23	First Health commercial percent of total billed charges · outpatientfrom % of charges	$209	$209	—	—	—	$209 – $209
24	MultiPlan commercial percent of total billed charges · outpatientfrom % of charges	$217	$217	—	—	—	$217 – $217

Last updated: May 18, 2026

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