Women's high-top depth shoe 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.

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Provider: anthropic
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Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Ladies shoes hightop depth i

Maple Grove, MN

See all hospitals reporting HCPCS L3217 →

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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 $103 is 9% below the median hospital's median price ($112), higher than 44% of the 328 hospitals reporting HCPCS L3217. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L3217 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 4 payers, 16 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	$51	$51	—	—	—	$51 – $51
2	Blue Cross Blue Shield federal fee schedule · outpatient	$51	$51	—	—	—	$51 – $51
3	Blue Cross Blue Shield commercial fee schedule · both	$52	$52	—	—	—	$52 – $52
4	Blue Cross Blue Shield commercial fee schedule · outpatient	$52	$52	—	—	—	$52 – $52
5	Blue Cross Blue Shield medicaid fee schedule · outpatient	$52	$52	—	—	—	$52 – $52
6	Medica ma non-snp fee schedule · both	$89	$89	—	—	—	$89 – $89
7	Medica ma snp fee schedule · both	$89	$89	—	—	—	$89 – $89
8	Medica prime solution fee schedule · both	$89	$89	—	—	—	$89 – $89
9	Medica vantage fee schedule · both	$89	$89	—	—	—	$89 – $89
10	Cigna commercial fee schedule · both	$112	$112	$10	9%	—	$103 – $122
11	Medica bold fee schedule · both	$160	$160	—	—	—	$160 – $160
12	Medica choice without / elect fee schedule · both	$178	$178	—	—	—	$178 – $178
13	Medica city of st paul / essential uplan fee schedule · both	$178	$178	—	—	—	$178 – $178
14	Medica choice with fee schedule · both	$184	$184	—	—	—	$184 – $184
15	UnitedHealthcare commercial fee schedule · both	$235	$235	—	—	—	$235 – $235
16	Cigna commercial fee schedule · outpatient	$236	$236	$21	9%	—	$215 – $257

Last updated: May 18, 2026

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