Lumbar back brace with rigid back panels 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

Lso sc r pos/lat pnl pre cst

Maple Grove, MN

See all hospitals reporting HCPCS L0633 →

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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 $390 is 8% above the median hospital's median price ($361), higher than 70% of the 891 hospitals reporting HCPCS L0633. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L0633 at Fairview Maple Grove Surgery Center

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	$296	$296	—	—	—	$296 – $296
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$301	$301	—	—	—	$301 – $301
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$301	$301	—	—	—	$301 – $301
4	Blue Cross Blue Shield federal fee schedule · both	$321	$321	—	—	—	$321 – $321
5	Blue Cross Blue Shield commercial fee schedule · both	$326	$326	—	—	—	$326 – $326
6	Medica accessability fee schedule · both	$337	$337	—	—	—	$337 – $337
7	Medica medicaid fee schedule · both	$337	$337	—	—	—	$337 – $337
8	Medica ma non-snp fee schedule · both	$366	$366	—	—	—	$366 – $366
9	Medica ma snp fee schedule · both	$366	$366	—	—	—	$366 – $366
10	Medica prime solution fee schedule · both	$366	$366	—	—	—	$366 – $366
11	Medica vantage fee schedule · both	$366	$366	—	—	—	$366 – $366
12	Blue Cross Blue Shield medicaid fee schedule · both	$368	$368	—	—	—	$368 – $368
13	Ucare mhcp fee schedule · both	$376	$376	—	—	—	$376 – $376
14	Cigna commercial fee schedule · both	$452	$452	$39	9%	—	$413 – $492
15	Ucare ifp with fairview fee schedule · outpatient	$608	$608	—	—	—	$608 – $608
16	Medica bold fee schedule · both	$636	$636	—	—	—	$636 – $636
17	UnitedHealthcare commercial fee schedule · both	$661	$661	—	—	—	$661 – $661
18	Medica choice without / elect fee schedule · both	$707	$707	—	—	—	$707 – $707
19	Medica city of st paul / essential uplan fee schedule · both	$707	$707	—	—	—	$707 – $707
20	Medica choice with fee schedule · both	$731	$731	—	—	—	$731 – $731
21	Ucare ifp fee schedule · outpatient	$810	$810	—	—	—	$810 – $810
22	Cigna commercial fee schedule · outpatient	$950	$950	$83	9%	—	$867 – $1.0k

Last updated: May 18, 2026

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