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.
Original text from hospital filings
Ak 4 bar link hydl swg/stanc
Maple Grove, MN
See all hospitals reporting HCPCS L5615 →Price type
Fairview Maple Grove Surgery Center’s median price of $8.9k is 24% above the median hospital's median price ($7.2k), higher than 79% of the 750 hospitals reporting HCPCS L5615. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 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 | $6.3k | $6.3k | — | — | — | $6.3k – $6.3k |
| 2 | Blue Cross Blue Shield commercial fee schedule · both | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
| 3 | Medica ma non-snp fee schedule · both | $7.2k | $7.2k | — | — | — | $7.2k – $7.2k |
| 4 | Medica ma snp fee schedule · both | $7.2k | $7.2k | — | — | — | $7.2k – $7.2k |
| 5 | Medica prime solution fee schedule · both | $7.2k | $7.2k | — | — | — | $7.2k – $7.2k |
| 6 | Medica vantage fee schedule · both | $7.2k | $7.2k | — | — | — | $7.2k – $7.2k |
| 7 | Ucare mhcp fee schedule · both | $7.4k | $7.4k | — | — | — | $7.4k – $7.4k |
| 8 | Cigna commercial fee schedule · both | $8.9k | $8.9k | $773 | 9% | — | $8.1k – $9.7k |
| 9 | Ucare ifp with fairview fee schedule · outpatient | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 10 | Medica bold fee schedule · both | $12.5k | $12.5k | — | — | — | $12.5k – $12.5k |
| 11 | Medica choice without / elect fee schedule · both | $13.9k | $13.9k | — | — | — | $13.9k – $13.9k |
| 12 | Medica city of st paul / essential uplan fee schedule · both | $13.9k | $13.9k | — | — | — | $13.9k – $13.9k |
| 13 | Medica choice with fee schedule · both | $14.4k | $14.4k | — | — | — | $14.4k – $14.4k |
| 14 | Ucare ifp fee schedule · outpatient | $15.9k | $15.9k | — | — | — | $15.9k – $15.9k |
| 15 | UnitedHealthcare commercial fee schedule · both | $16.3k | $16.3k | — | — | — | $16.3k – $16.3k |
| 16 | Cigna commercial fee schedule · outpatient | $18.7k | $18.7k | $1.6k | 9% | — | $17.1k – $20.3k |
Last updated: May 18, 2026
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