Emicizumab injection, 0.5 mg 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

EMICIZUMAB-KXWH 300 MG/2ML SC SOLN

Maple Grove, MN

See all hospitals reporting HCPCS J7170 →

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $82 is 22% above the median hospital's median price ($68), higher than 61% of the 1,245 hospitals reporting HCPCS J7170. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J7170 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	Blue Cross Blue Shield federal fee schedule · outpatient	$50	$50	—	—	—	$50 – $50
2	Blue Cross Blue Shield federal fee schedule · both	$51	$51	—	—	—	$51 – $51
3	Blue Cross Blue Shield commercial fee schedule · outpatient	$51	$51	—	—	—	$51 – $51
4	Blue Cross Blue Shield medicaid fee schedule · outpatient	$51	$51	—	—	—	$51 – $51
5	Blue Cross Blue Shield commercial fee schedule · both	$52	$52	—	—	—	$52 – $52
6	Medica accessability fee schedule · both	$53	$53	—	—	—	$53 – $53
7	Medica medicaid fee schedule · both	$53	$53	—	—	—	$53 – $53
8	Ucare mhcp fee schedule · both	$55	$55	—	—	—	$55 – $55
9	Medica ma non-snp fee schedule · both	$55	$55	—	—	—	$55 – $55
10	Medica ma snp fee schedule · both	$55	$55	—	—	—	$55 – $55
11	Medica prime solution fee schedule · both	$55	$55	—	—	—	$55 – $55
12	Medica vantage fee schedule · both	$55	$55	—	—	—	$55 – $55
13	UnitedHealthcare medicare advantage fee schedule · outpatient	$55	$55	—	—	—	$55 – $55
14	Blue Cross Blue Shield medicare advantage fee schedule · outpatient	$57	$57	—	—	—	$57 – $57
15	Blue Cross Blue Shield medicaid fee schedule · both	$58	$58	—	—	—	$58 – $58
16	Cigna commercial fee schedule · both	$61	$61	$5	9%	—	$55 – $66
17	Medicaid medicaid fee schedule · both	$61	$61	—	—	—	$61 – $61
18	Ucare ifp with fairview fee schedule · outpatient	$95	$95	—	—	—	$95 – $95
19	Medica bold fee schedule · both	$96	$96	—	—	—	$96 – $96
20	UnitedHealthcare commercial fee schedule · both	$96	$96	—	—	—	$96 – $96
21	Cigna commercial fee schedule · outpatient	$97	$97	$8	9%	—	$88 – $105
22	Medica choice without / elect fee schedule · both	$106	$106	—	—	—	$106 – $106
23	Medica city of st paul / essential uplan fee schedule · both	$106	$106	—	—	—	$106 – $106
24	Medica choice with fee schedule · both	$110	$110	—	—	—	$110 – $110
25	Ucare ifp fee schedule · outpatient	$127	$127	—	—	—	$127 – $127

Page 1 of 2 · 27 rates

Last updated: May 18, 2026

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