Prosthetic leg addition: pelvic band for above-knee prosthesis 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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Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Ak/knee disartic pelvic band

Maple Grove, MN

See all hospitals reporting HCPCS L5697 →

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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 $126 is 17% above the median hospital's median price ($107), higher than 70% of the 832 hospitals reporting HCPCS L5697. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L5697 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	$96	$96	—	—	—	$96 – $96
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$98	$98	—	—	—	$98 – $98
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$98	$98	—	—	—	$98 – $98
4	Blue Cross Blue Shield federal fee schedule · both	$104	$104	—	—	—	$104 – $104
5	Blue Cross Blue Shield commercial fee schedule · both	$106	$106	—	—	—	$106 – $106
6	Medica accessability fee schedule · both	$110	$110	—	—	—	$110 – $110
7	Medica medicaid fee schedule · both	$110	$110	—	—	—	$110 – $110
8	Medica ma non-snp fee schedule · both	$119	$119	—	—	—	$119 – $119
9	Medica ma snp fee schedule · both	$119	$119	—	—	—	$119 – $119
10	Medica prime solution fee schedule · both	$119	$119	—	—	—	$119 – $119
11	Medica vantage fee schedule · both	$119	$119	—	—	—	$119 – $119
12	Blue Cross Blue Shield medicaid fee schedule · both	$119	$119	—	—	—	$119 – $119
13	Ucare mhcp fee schedule · both	$122	$122	—	—	—	$122 – $122
14	Cigna commercial fee schedule · both	$147	$147	$13	9%	—	$134 – $160
15	Ucare ifp with fairview fee schedule · outpatient	$197	$197	—	—	—	$197 – $197
16	UnitedHealthcare commercial fee schedule · both	$206	$206	—	—	—	$206 – $206
17	Medica bold fee schedule · both	$207	$207	—	—	—	$207 – $207
18	Medica choice without / elect fee schedule · both	$230	$230	—	—	—	$230 – $230
19	Medica city of st paul / essential uplan fee schedule · both	$230	$230	—	—	—	$230 – $230
20	Medica choice with fee schedule · both	$238	$238	—	—	—	$238 – $238
21	Ucare ifp fee schedule · outpatient	$263	$263	—	—	—	$263 – $263
22	Cigna commercial fee schedule · outpatient	$309	$309	$27	9%	—	$282 – $336

Last updated: May 18, 2026

Compare to other hospitals

See Prosthetic leg addition: pelvic band for above-knee prosthesis pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.