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
Non-molded lacer
Maple Grove, MN
See all hospitals reporting HCPCS L2320 →Price type
Fairview Maple Grove Surgery Center’s median price of $260 is 3% below the median hospital's median price ($268), higher than 44% of the 881 hospitals reporting HCPCS L2320. 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 | $199 | $199 | — | — | — | $199 – $199 |
| 2 | Blue Cross Blue Shield commercial fee schedule · outpatient | $203 | $203 | — | — | — | $203 – $203 |
| 3 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $203 | $203 | — | — | — | $203 – $203 |
| 4 | Blue Cross Blue Shield federal fee schedule · both | $216 | $216 | — | — | — | $216 – $216 |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $220 | $220 | — | — | — | $220 – $220 |
| 6 | Medica accessability fee schedule · both | $227 | $227 | — | — | — | $227 – $227 |
| 7 | Medica medicaid fee schedule · both | $227 | $227 | — | — | — | $227 – $227 |
| 8 | Medica ma non-snp fee schedule · both | $246 | $246 | — | — | — | $246 – $246 |
| 9 | Medica ma snp fee schedule · both | $246 | $246 | — | — | — | $246 – $246 |
| 10 | Medica prime solution fee schedule · both | $246 | $246 | — | — | — | $246 – $246 |
| 11 | Medica vantage fee schedule · both | $246 | $246 | — | — | — | $246 – $246 |
| 12 | Blue Cross Blue Shield medicaid fee schedule · both | $247 | $247 | — | — | — | $247 – $247 |
| 13 | Ucare mhcp fee schedule · both | $253 | $253 | — | — | — | $253 – $253 |
| 14 | Cigna commercial fee schedule · both | $304 | $304 | $26 | 9% | — | $278 – $331 |
| 15 | Ucare ifp with fairview fee schedule · outpatient | $409 | $409 | — | — | — | $409 – $409 |
| 16 | Medica bold fee schedule · both | $428 | $428 | — | — | — | $428 – $428 |
| 17 | Medica choice without / elect fee schedule · both | $476 | $476 | — | — | — | $476 – $476 |
| 18 | Medica city of st paul / essential uplan fee schedule · both | $476 | $476 | — | — | — | $476 – $476 |
| 19 | Medica choice with fee schedule · both | $492 | $492 | — | — | — | $492 – $492 |
| 20 | UnitedHealthcare commercial fee schedule · both | $496 | $496 | — | — | — | $496 – $496 |
| 21 | Ucare ifp fee schedule · outpatient | $545 | $545 | — | — | — | $545 – $545 |
| 22 | Cigna commercial fee schedule · outpatient | $639 | $639 | $56 | 9% | — | $583 – $694 |
Last updated: May 18, 2026
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