Custom hand and finger brace with elastic bands 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
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HFO w/joint(s) CF

Maple Grove, MN

See all hospitals reporting HCPCS L3921 →

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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 $398 is 9% above the median hospital's median price ($364), higher than 72% of the 1,216 hospitals reporting HCPCS L3921. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L3921 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	$302	$302	—	—	—	$302 – $302
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$307	$307	—	—	—	$307 – $307
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$307	$307	—	—	—	$307 – $307
4	Blue Cross Blue Shield federal fee schedule · both	$327	$327	—	—	—	$327 – $327
5	Blue Cross Blue Shield commercial fee schedule · both	$333	$333	—	—	—	$333 – $333
6	Medica accessability fee schedule · both	$344	$344	—	—	—	$344 – $344
7	Medica medicaid fee schedule · both	$344	$344	—	—	—	$344 – $344
8	Medica ma non-snp fee schedule · both	$373	$373	—	—	—	$373 – $373
9	Medica ma snp fee schedule · both	$373	$373	—	—	—	$373 – $373
10	Medica prime solution fee schedule · both	$373	$373	—	—	—	$373 – $373
11	Medica vantage fee schedule · both	$373	$373	—	—	—	$373 – $373
12	Blue Cross Blue Shield medicaid fee schedule · both	$375	$375	—	—	—	$375 – $375
13	Ucare mhcp fee schedule · both	$384	$384	—	—	—	$384 – $384
14	Cigna commercial fee schedule · both	$461	$461	$40	9%	—	$421 – $502
15	Ucare ifp with fairview fee schedule · outpatient	$619	$619	—	—	—	$619 – $619
16	Medica bold fee schedule · both	$649	$649	—	—	—	$649 – $649
17	UnitedHealthcare commercial fee schedule · both	$674	$674	—	—	—	$674 – $674
18	Medica choice without / elect fee schedule · both	$721	$721	—	—	—	$721 – $721
19	Medica city of st paul / essential uplan fee schedule · both	$721	$721	—	—	—	$721 – $721
20	Medica choice with fee schedule · both	$746	$746	—	—	—	$746 – $746
21	Ucare ifp fee schedule · outpatient	$826	$826	—	—	—	$826 – $826
22	Cigna commercial fee schedule · outpatient	$969	$969	$84	9%	—	$885 – $1.1k

Last updated: May 18, 2026

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