Shoulder abduction restraint vest, prefabricated 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

So vest canvas/web pre ots

Maple Grove, MN

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Pricing by billing methodology

Price type

How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $215 is 7% above the median hospital's median price ($201), higher than 69% of the 933 hospitals reporting HCPCS L3675. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L3675 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	$165	$165	—	—	—	$165 – $165
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$168	$168	—	—	—	$168 – $168
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$168	$168	—	—	—	$168 – $168
4	Blue Cross Blue Shield federal fee schedule · both	$179	$179	—	—	—	$179 – $179
5	Blue Cross Blue Shield commercial fee schedule · both	$182	$182	—	—	—	$182 – $182
6	Medica accessability fee schedule · both	$188	$188	—	—	—	$188 – $188
7	Medica medicaid fee schedule · both	$188	$188	—	—	—	$188 – $188
8	Medica ma non-snp fee schedule · both	$204	$204	—	—	—	$204 – $204
9	Medica ma snp fee schedule · both	$204	$204	—	—	—	$204 – $204
10	Medica prime solution fee schedule · both	$204	$204	—	—	—	$204 – $204
11	Medica vantage fee schedule · both	$204	$204	—	—	—	$204 – $204
12	Blue Cross Blue Shield medicaid fee schedule · both	$205	$205	—	—	—	$205 – $205
13	Ucare mhcp fee schedule · both	$210	$210	—	—	—	$210 – $210
14	Cigna commercial fee schedule · both	$252	$252	$22	9%	—	$230 – $274
15	Ucare ifp with fairview fee schedule · outpatient	$338	$338	—	—	—	$338 – $338
16	Medica bold fee schedule · both	$354	$354	—	—	—	$354 – $354
17	UnitedHealthcare commercial fee schedule · both	$368	$368	—	—	—	$368 – $368
18	Medica choice without / elect fee schedule · both	$394	$394	—	—	—	$394 – $394
19	Medica city of st paul / essential uplan fee schedule · both	$394	$394	—	—	—	$394 – $394
20	Medica choice with fee schedule · both	$407	$407	—	—	—	$407 – $407
21	Ucare ifp fee schedule · outpatient	$451	$451	—	—	—	$451 – $451
22	Cigna commercial fee schedule · outpatient	$529	$529	$46	9%	—	$483 – $575

Last updated: May 18, 2026

Compare to other hospitals

See Shoulder abduction restraint vest, prefabricated pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.