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
Cerv semi-rig adj molded chn
Maple Grove, MN
See all hospitals reporting HCPCS L0150 →Price type
Fairview Maple Grove Surgery Center’s median price of $144 is 10% above the median hospital's median price ($132), higher than 63% of the 1,144 hospitals reporting HCPCS L0150. 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 | Blue Cross Blue Shield federal fee schedule · outpatient | $110 | $110 | — | — | — | $110 – $110 |
| 2 | Blue Cross Blue Shield commercial fee schedule · outpatient | $112 | $112 | — | — | — | $112 – $112 |
| 3 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $112 | $112 | — | — | — | $112 – $112 |
| 4 | Blue Cross Blue Shield federal fee schedule · both | $120 | $120 | — | — | — | $120 – $120 |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $122 | $122 | — | — | — | $122 – $122 |
| 6 | Medica accessability fee schedule · both | $126 | $126 | — | — | — | $126 – $126 |
| 7 | Medica medicaid fee schedule · both | $126 | $126 | — | — | — | $126 – $126 |
| 8 | Medica ma non-snp fee schedule · both | $137 | $137 | — | — | — | $137 – $137 |
| 9 | Medica ma snp fee schedule · both | $137 | $137 | — | — | — | $137 – $137 |
| 10 | Medica prime solution fee schedule · both | $137 | $137 | — | — | — | $137 – $137 |
| 11 | Medica vantage fee schedule · both | $137 | $137 | — | — | — | $137 – $137 |
| 12 | Blue Cross Blue Shield medicaid fee schedule · both | $137 | $137 | — | — | — | $137 – $137 |
| 13 | Ucare mhcp fee schedule · both | $140 | $140 | — | — | — | $140 – $140 |
| 14 | Cigna commercial fee schedule · both | $169 | $169 | $15 | 9% | — | $154 – $184 |
| 15 | Ucare ifp with fairview fee schedule · outpatient | $227 | $227 | — | — | — | $227 – $227 |
| 16 | Medica bold fee schedule · both | $237 | $237 | — | — | — | $237 – $237 |
| 17 | UnitedHealthcare commercial fee schedule · both | $261 | $261 | — | — | — | $261 – $261 |
| 18 | Medica choice without / elect fee schedule · both | $264 | $264 | — | — | — | $264 – $264 |
| 19 | Medica city of st paul / essential uplan fee schedule · both | $264 | $264 | — | — | — | $264 – $264 |
| 20 | Medica choice with fee schedule · both | $273 | $273 | — | — | — | $273 – $273 |
| 21 | Ucare ifp fee schedule · outpatient | $302 | $302 | — | — | — | $302 – $302 |
| 22 | Cigna commercial fee schedule · outpatient | $355 | $355 | $31 | 9% | — | $324 – $386 |
Last updated: May 18, 2026
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