Bilateral pelvic control belt for lower-extremity orthosis 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
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Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Pelvic control band & belt b

Maple Grove, MN

See all hospitals reporting HCPCS L2640 →

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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 $423 is about the same as the median hospital's median price ($423), higher than 50% of the 864 hospitals reporting HCPCS L2640. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L2640 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	$324	$324	—	—	—	$324 – $324
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$330	$330	—	—	—	$330 – $330
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$330	$330	—	—	—	$330 – $330
4	Blue Cross Blue Shield federal fee schedule · both	$351	$351	—	—	—	$351 – $351
5	Blue Cross Blue Shield commercial fee schedule · both	$358	$358	—	—	—	$358 – $358
6	Medica accessability fee schedule · both	$370	$370	—	—	—	$370 – $370
7	Medica medicaid fee schedule · both	$370	$370	—	—	—	$370 – $370
8	Medica ma non-snp fee schedule · both	$401	$401	—	—	—	$401 – $401
9	Medica ma snp fee schedule · both	$401	$401	—	—	—	$401 – $401
10	Medica prime solution fee schedule · both	$401	$401	—	—	—	$401 – $401
11	Medica vantage fee schedule · both	$401	$401	—	—	—	$401 – $401
12	Blue Cross Blue Shield medicaid fee schedule · both	$403	$403	—	—	—	$403 – $403
13	Ucare mhcp fee schedule · both	$412	$412	—	—	—	$412 – $412
14	Cigna commercial fee schedule · both	$496	$496	$43	9%	—	$453 – $539
15	Ucare ifp with fairview fee schedule · outpatient	$666	$666	—	—	—	$666 – $666
16	Medica bold fee schedule · both	$697	$697	—	—	—	$697 – $697
17	Medica choice without / elect fee schedule · both	$775	$775	—	—	—	$775 – $775
18	Medica city of st paul / essential uplan fee schedule · both	$775	$775	—	—	—	$775 – $775
19	Medica choice with fee schedule · both	$802	$802	—	—	—	$802 – $802
20	UnitedHealthcare commercial fee schedule · both	$811	$811	—	—	—	$811 – $811
21	Ucare ifp fee schedule · outpatient	$887	$887	—	—	—	$887 – $887
22	Cigna commercial fee schedule · outpatient	$1.0k	$1.0k	$91	9%	—	$950 – $1.1k

Last updated: May 18, 2026

Compare to other hospitals

See Bilateral pelvic control belt for lower-extremity orthosis pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.