Sio panel custom at Fairview Maple Grove Surgery Center

Maple Grove, MN

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Pricing by billing methodology

Price type

How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $38 is 50% below the median hospital's median price ($75), higher than 16% of the 178 hospitals reporting HCPCS L0624. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L0624 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 1 payer, 5 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	$37	$37	—	—	—	$37 – $37
2	Blue Cross Blue Shield federal fee schedule · outpatient	$37	$37	—	—	—	$37 – $37
3	Blue Cross Blue Shield commercial fee schedule · both	$38	$38	—	—	—	$38 – $38
4	Blue Cross Blue Shield commercial fee schedule · outpatient	$38	$38	—	—	—	$38 – $38
5	Blue Cross Blue Shield medicaid fee schedule · outpatient	$38	$38	—	—	—	$38 – $38

Last updated: May 18, 2026

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HCPCS L0624