Prosthetic knee joint add-on, polycentric, pair 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

Bk knee joints polycentric p

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 $745 is 10% above the median hospital's median price ($679), higher than 58% of the 834 hospitals reporting HCPCS L5677. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L5677 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	$571	$571	—	—	—	$571 – $571
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$581	$581	—	—	—	$581 – $581
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$581	$581	—	—	—	$581 – $581
4	Blue Cross Blue Shield federal fee schedule · both	$618	$618	—	—	—	$618 – $618
5	Blue Cross Blue Shield commercial fee schedule · both	$629	$629	—	—	—	$629 – $629
6	Medica accessability fee schedule · both	$650	$650	—	—	—	$650 – $650
7	Medica medicaid fee schedule · both	$650	$650	—	—	—	$650 – $650
8	Medica ma non-snp fee schedule · both	$706	$706	—	—	—	$706 – $706
9	Medica ma snp fee schedule · both	$706	$706	—	—	—	$706 – $706
10	Medica prime solution fee schedule · both	$706	$706	—	—	—	$706 – $706
11	Medica vantage fee schedule · both	$706	$706	—	—	—	$706 – $706
12	Blue Cross Blue Shield medicaid fee schedule · both	$709	$709	—	—	—	$709 – $709
13	Ucare mhcp fee schedule · both	$726	$726	—	—	—	$726 – $726
14	Cigna commercial fee schedule · both	$872	$872	$76	9%	—	$796 – $948
15	Ucare ifp with fairview fee schedule · outpatient	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k
16	Medica bold fee schedule · both	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k
17	UnitedHealthcare commercial fee schedule · both	$1.3k	$1.3k	—	—	—	$1.3k – $1.3k
18	Medica choice without / elect fee schedule · both	$1.4k	$1.4k	—	—	—	$1.4k – $1.4k
19	Medica city of st paul / essential uplan fee schedule · both	$1.4k	$1.4k	—	—	—	$1.4k – $1.4k
20	Medica choice with fee schedule · both	$1.4k	$1.4k	—	—	—	$1.4k – $1.4k
21	Ucare ifp fee schedule · outpatient	$1.6k	$1.6k	—	—	—	$1.6k – $1.6k
22	Cigna commercial fee schedule · outpatient	$1.8k	$1.8k	$159	9%	—	$1.7k – $2.0k

Last updated: May 18, 2026

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