Below-knee prosthetic leg addition, ultra-light material 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

Endo bk ultra-light material

Maple Grove, MN

See all hospitals reporting HCPCS L5940 →

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Pricing by billing methodology

Price type

How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $674 is 5% below the median hospital's median price ($706), higher than 46% of the 882 hospitals reporting HCPCS L5940. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L5940 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	$516	$516	—	—	—	$516 – $516
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$525	$525	—	—	—	$525 – $525
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$525	$525	—	—	—	$525 – $525
4	Blue Cross Blue Shield federal fee schedule · both	$559	$559	—	—	—	$559 – $559
5	Blue Cross Blue Shield commercial fee schedule · both	$569	$569	—	—	—	$569 – $569
6	Medica accessability fee schedule · both	$588	$588	—	—	—	$588 – $588
7	Medica medicaid fee schedule · both	$588	$588	—	—	—	$588 – $588
8	Medica ma non-snp fee schedule · both	$638	$638	—	—	—	$638 – $638
9	Medica ma snp fee schedule · both	$638	$638	—	—	—	$638 – $638
10	Medica prime solution fee schedule · both	$638	$638	—	—	—	$638 – $638
11	Medica vantage fee schedule · both	$638	$638	—	—	—	$638 – $638
12	Blue Cross Blue Shield medicaid fee schedule · both	$640	$640	—	—	—	$640 – $640
13	Ucare mhcp fee schedule · both	$656	$656	—	—	—	$656 – $656
14	Cigna commercial fee schedule · both	$788	$788	$69	9%	—	$720 – $857
15	Ucare ifp with fairview fee schedule · outpatient	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
16	Medica bold fee schedule · both	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
17	Medica choice without / elect fee schedule · both	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k
18	Medica city of st paul / essential uplan fee schedule · both	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k
19	Medica choice with fee schedule · both	$1.3k	$1.3k	—	—	—	$1.3k – $1.3k
20	UnitedHealthcare commercial fee schedule · both	$1.3k	$1.3k	—	—	—	$1.3k – $1.3k
21	Ucare ifp fee schedule · outpatient	$1.4k	$1.4k	—	—	—	$1.4k – $1.4k
22	Cigna commercial fee schedule · outpatient	$1.7k	$1.7k	$144	9%	—	$1.5k – $1.8k

Last updated: May 18, 2026

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