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
Halo repl liner/interface
Maple Grove, MN
See all hospitals reporting HCPCS L0861 →Price type
Fairview Maple Grove Surgery Center’s median price of $291 is 6% above the median hospital's median price ($274), higher than 64% of the 907 hospitals reporting HCPCS L0861. 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 | $222 | $222 | — | — | — | $222 – $222 |
| 2 | Blue Cross Blue Shield commercial fee schedule · outpatient | $226 | $226 | — | — | — | $226 – $226 |
| 3 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $226 | $226 | — | — | — | $226 – $226 |
| 4 | Blue Cross Blue Shield federal fee schedule · both | $241 | $241 | — | — | — | $241 – $241 |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $245 | $245 | — | — | — | $245 – $245 |
| 6 | Medica accessability fee schedule · both | $254 | $254 | — | — | — | $254 – $254 |
| 7 | Medica medicaid fee schedule · both | $254 | $254 | — | — | — | $254 – $254 |
| 8 | Medica ma non-snp fee schedule · both | $275 | $275 | — | — | — | $275 – $275 |
| 9 | Medica ma snp fee schedule · both | $275 | $275 | — | — | — | $275 – $275 |
| 10 | Medica prime solution fee schedule · both | $275 | $275 | — | — | — | $275 – $275 |
| 11 | Medica vantage fee schedule · both | $275 | $275 | — | — | — | $275 – $275 |
| 12 | Blue Cross Blue Shield medicaid fee schedule · both | $276 | $276 | — | — | — | $276 – $276 |
| 13 | Ucare mhcp fee schedule · both | $283 | $283 | — | — | — | $283 – $283 |
| 14 | Cigna commercial fee schedule · both | $340 | $340 | $30 | 9% | — | $311 – $370 |
| 15 | Ucare ifp with fairview fee schedule · outpatient | $457 | $457 | — | — | — | $457 – $457 |
| 16 | Medica bold fee schedule · both | $478 | $478 | — | — | — | $478 – $478 |
| 17 | UnitedHealthcare commercial fee schedule · both | $497 | $497 | — | — | — | $497 – $497 |
| 18 | Medica choice without / elect fee schedule · both | $531 | $531 | — | — | — | $531 – $531 |
| 19 | Medica city of st paul / essential uplan fee schedule · both | $531 | $531 | — | — | — | $531 – $531 |
| 20 | Medica choice with fee schedule · both | $550 | $550 | — | — | — | $550 – $550 |
| 21 | Ucare ifp fee schedule · outpatient | $609 | $609 | — | — | — | $609 – $609 |
| 22 | Cigna commercial fee schedule · outpatient | $714 | $714 | $62 | 9% | — | $652 – $777 |
Last updated: May 18, 2026
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