Hydroxyzine hydrochloride 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-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HYDROXYZINE HCL 50 MG/ML IM SOLN

Maple Grove, MN

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $27 is 17% below the median hospital's median price ($32), higher than 41% of the 2,079 hospitals reporting HCPCS J3410. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J3410 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 · both	$10	$10	—	—	—	$10 – $10
2	Blue Cross Blue Shield commercial fee schedule · both	$10	$10	—	—	—	$10 – $10
3	Blue Cross Blue Shield federal fee schedule · outpatient	$11	$11	—	—	—	$11 – $11
4	Blue Cross Blue Shield commercial fee schedule · outpatient	$11	$11	—	—	—	$11 – $11
5	Blue Cross Blue Shield medicaid fee schedule · outpatient	$11	$11	—	—	—	$11 – $11
6	Medica accessability fee schedule · both	$12	$12	—	—	—	$12 – $12
7	Medica medicaid fee schedule · both	$12	$12	—	—	—	$12 – $12
8	Medica ma non-snp fee schedule · both	$13	$13	—	—	—	$13 – $13
9	Medica ma snp fee schedule · both	$13	$13	—	—	—	$13 – $13
10	Medica prime solution fee schedule · both	$13	$13	—	—	—	$13 – $13
11	Medica vantage fee schedule · both	$13	$13	—	—	—	$13 – $13
12	Blue Cross Blue Shield medicaid fee schedule · both	$14	$14	—	—	—	$14 – $14
13	Ucare mhcp fee schedule · both	$16	$16	—	—	—	$16 – $16
14	Cigna commercial fee schedule · both	$17	$17	$1	9%	—	$15 – $18
15	Medicaid medicaid fee schedule · both	$18	$18	—	—	—	$18 – $18
16	Medica bold fee schedule · both	$19	$19	—	—	—	$19 – $19
17	Medica choice without / elect fee schedule · both	$21	$21	—	—	—	$21 – $21
18	Medica city of st paul / essential uplan fee schedule · both	$21	$21	—	—	—	$21 – $21
19	Medica choice with fee schedule · both	$21	$21	—	—	—	$21 – $21
20	UnitedHealthcare commercial fee schedule · both	$23	$23	—	—	—	$23 – $23
21	Ucare ifp percent of total billed charges · outpatientfrom % of charges	$51	$59	$47	79%	—	$10 – $204
22	Ucare ifp with fairview percent of total billed charges · outpatientfrom % of charges	$51	$59	$47	79%	—	$10 – $204
23	First Health commercial percent of total billed charges · outpatientfrom % of charges	$83	$96	$77	79%	—	$16 – $334
24	MultiPlan commercial percent of total billed charges · outpatientfrom % of charges	$86	$100	$79	79%	—	$16 – $346

Last updated: May 18, 2026

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