Prefabricated rigid elbow brace without joints 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

Eo rigid w/o joints pre ots

Maple Grove, MN

See all hospitals reporting HCPCS L3762 →

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $132 is 9% above the median hospital's median price ($122), higher than 72% of the 1,137 hospitals reporting HCPCS L3762. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L3762 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	$101	$101	—	—	—	$101 – $101
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$103	$103	—	—	—	$103 – $103
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$103	$103	—	—	—	$103 – $103
4	Blue Cross Blue Shield federal fee schedule · both	$109	$109	—	—	—	$109 – $109
5	Blue Cross Blue Shield commercial fee schedule · both	$111	$111	—	—	—	$111 – $111
6	Medica accessability fee schedule · both	$115	$115	—	—	—	$115 – $115
7	Medica medicaid fee schedule · both	$115	$115	—	—	—	$115 – $115
8	Medica ma non-snp fee schedule · both	$125	$125	—	—	—	$125 – $125
9	Medica ma snp fee schedule · both	$125	$125	—	—	—	$125 – $125
10	Medica prime solution fee schedule · both	$125	$125	—	—	—	$125 – $125
11	Medica vantage fee schedule · both	$125	$125	—	—	—	$125 – $125
12	Blue Cross Blue Shield medicaid fee schedule · both	$125	$125	—	—	—	$125 – $125
13	Ucare mhcp fee schedule · both	$128	$128	—	—	—	$128 – $128
14	Cigna commercial fee schedule · both	$155	$155	$13	9%	—	$141 – $168
15	Ucare ifp with fairview fee schedule · outpatient	$207	$207	—	—	—	$207 – $207
16	Medica bold fee schedule · both	$217	$217	—	—	—	$217 – $217
17	UnitedHealthcare commercial fee schedule · both	$226	$226	—	—	—	$226 – $226
18	Medica choice without / elect fee schedule · both	$241	$241	—	—	—	$241 – $241
19	Medica city of st paul / essential uplan fee schedule · both	$241	$241	—	—	—	$241 – $241
20	Medica choice with fee schedule · both	$250	$250	—	—	—	$250 – $250
21	Ucare ifp fee schedule · outpatient	$276	$276	—	—	—	$276 – $276
22	Cigna commercial fee schedule · outpatient	$325	$325	$28	9%	—	$296 – $353

Last updated: May 18, 2026

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