Andexxa injection, 10 mg (coagulation reversal agent) 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

COAG FACT XA INACTIVATED-ZHZO IVPB

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 $136 is 27% below the median hospital's median price ($186), higher than 33% of the 1,227 hospitals reporting HCPCS J7169. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J7169 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 8 payers, 28 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	Cigna commercial fee schedule · outpatient	$99	$99	$9	9%	—	$91 – $108
2	Ucare mhcp fee schedule · both	$120	$120	—	—	—	$120 – $120
3	Medica accessability fee schedule · both	$125	$125	—	—	—	$125 – $125
4	Medica medicaid fee schedule · both	$125	$125	—	—	—	$125 – $125
5	Blue Cross Blue Shield federal fee schedule · both	$128	$128	—	—	—	$128 – $128
6	Blue Cross Blue Shield federal fee schedule · outpatient	$128	$128	—	—	—	$128 – $128
7	UnitedHealthcare medicare advantage fee schedule · outpatient	$129	$129	—	—	—	$129 – $129
8	Blue Cross Blue Shield commercial fee schedule · both	$130	$130	—	—	—	$130 – $130
9	Blue Cross Blue Shield commercial fee schedule · outpatient	$130	$130	—	—	—	$130 – $130
10	Blue Cross Blue Shield medicaid fee schedule · outpatient	$130	$130	—	—	—	$130 – $130
11	Medicaid medicaid fee schedule · both	$134	$134	—	—	—	$134 – $134
12	Blue Cross Blue Shield medicare advantage fee schedule · outpatient	$134	$134	—	—	—	$134 – $134
13	Blue Cross Blue Shield medicaid fee schedule · both	$136	$136	—	—	—	$136 – $136
14	Medica ma non-snp fee schedule · both	$136	$136	—	—	—	$136 – $136
15	Medica ma snp fee schedule · both	$136	$136	—	—	—	$136 – $136
16	Medica prime solution fee schedule · both	$136	$136	—	—	—	$136 – $136
17	Medica vantage fee schedule · both	$136	$136	—	—	—	$136 – $136
18	Ucare ifp with fairview fee schedule · outpatient	$223	$223	—	—	—	$223 – $223
19	UnitedHealthcare commercial fee schedule · both	$233	$233	—	—	—	$233 – $233
20	Medica bold fee schedule · both	$243	$243	—	—	—	$243 – $243
21	Ucare ifp with fairview fee schedule · both	$266	$266	—	—	—	$266 – $266
22	Medica choice without / elect fee schedule · both	$270	$270	—	—	—	$270 – $270
23	Medica city of st paul / essential uplan fee schedule · both	$270	$270	—	—	—	$270 – $270
24	Medica choice with fee schedule · both	$279	$279	—	—	—	$279 – $279
25	Ucare ifp fee schedule · both	$280	$280	—	—	—	$280 – $280

Page 1 of 2 · 28 rates

Last updated: May 18, 2026

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