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.
Original text from hospital filings
PWC gp 3 xhd cap chair
Maple Grove, MN
See all hospitals reporting HCPCS K0855 →Price type
Fairview Maple Grove Surgery Center’s median price of $3.4k is 91% above the median hospital's median price ($1.8k), higher than 65% of the 570 hospitals reporting HCPCS K0855. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 22 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 ma non-snp fee schedule · both | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 2 | Medica ma snp fee schedule · both | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 3 | Medica prime solution fee schedule · both | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 4 | Medica vantage fee schedule · both | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 5 | Ucare ifp with fairview fee schedule · outpatient | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 6 | Medica bold fee schedule · both | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 7 | Medica choice without / elect fee schedule · both | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 8 | Medica city of st paul / essential uplan fee schedule · both | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 9 | Medica choice with fee schedule · both | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 10 | Ucare ifp fee schedule · outpatient | $3.9k | $3.9k | — | — | — | $3.9k – $3.9k |
| 11 | Blue Cross Blue Shield medicaid fee schedule · both | $6.7k | $6.7k | $5.0k | 74% | — | $1.7k – $11.7k |
| 12 | Ucare mhcp fee schedule · both | $6.9k | $6.9k | $5.1k | 74% | — | $1.8k – $11.9k |
| 13 | Blue Cross Blue Shield commercial fee schedule · both | $8.8k | $8.8k | $7.2k | 82% | — | $1.6k – $16.0k |
| 14 | Blue Cross Blue Shield federal fee schedule · both | $8.8k | $8.8k | $7.2k | 82% | — | $1.6k – $16.0k |
| 15 | Medica accessability fee schedule · both | $10.7k | $10.7k | — | — | — | $10.7k – $10.7k |
| 16 | Medica medicaid fee schedule · both | $10.7k | $10.7k | — | — | — | $10.7k – $10.7k |
| 17 | Cigna commercial fee schedule · both | $11.0k | $11.8k | $9.8k | 83% | — | $2.0k – $23.4k |
| 18 | UnitedHealthcare commercial fee schedule · both | $20.0k | $14.3k | $8.0k | 56% | — | $3.0k – $20.0k |
| 19 | Blue Cross Blue Shield federal fee schedule · outpatient | $14.8k | $14.8k | — | — | — | $14.8k – $14.8k |
| 20 | Blue Cross Blue Shield commercial fee schedule · outpatient | $15.1k | $15.1k | — | — | — | $15.1k – $15.1k |
| 21 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $15.1k | $15.1k | — | — | — | $15.1k – $15.1k |
| 22 | Cigna commercial fee schedule · outpatient | $45.2k | $45.2k | $3.9k | 9% | — | $41.3k – $49.2k |
Last updated: May 18, 2026
See Power wheelchair, extra heavy duty, 601+ lb capacity pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.