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
Replc sockt below e/w disa
Maple Grove, MN
See all hospitals reporting HCPCS L6883 →Price type
Fairview Maple Grove Surgery Center’s median price of $2.7k is 15% above the median hospital's median price ($2.4k), higher than 79% of the 818 hospitals reporting HCPCS L6883. 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, 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 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 2 | Blue Cross Blue Shield commercial fee schedule · outpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 3 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 4 | Blue Cross Blue Shield federal fee schedule · both | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 6 | Medica accessability fee schedule · both | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 7 | Medica medicaid fee schedule · both | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 8 | Blue Cross Blue Shield medicaid fee schedule · both | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 9 | Medica ma non-snp fee schedule · both | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 10 | Medica ma snp fee schedule · both | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 11 | Medica prime solution fee schedule · both | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 12 | Medica vantage fee schedule · both | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 13 | Ucare mhcp fee schedule · both | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 14 | Cigna commercial fee schedule · both | $3.1k | $3.1k | $273 | 9% | — | $2.9k – $3.4k |
| 15 | UnitedHealthcare commercial fee schedule · both | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 16 | Ucare ifp with fairview fee schedule · outpatient | $4.2k | $4.2k | — | — | — | $4.2k – $4.2k |
| 17 | Medica bold fee schedule · both | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 18 | Medica choice without / elect fee schedule · both | $4.9k | $4.9k | — | — | — | $4.9k – $4.9k |
| 19 | Medica city of st paul / essential uplan fee schedule · both | $4.9k | $4.9k | — | — | — | $4.9k – $4.9k |
| 20 | Medica choice with fee schedule · both | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 21 | Ucare ifp fee schedule · outpatient | $5.6k | $5.6k | — | — | — | $5.6k – $5.6k |
| 22 | Cigna commercial fee schedule · outpatient | $6.6k | $6.6k | $573 | 9% | — | $6.0k – $7.2k |
Last updated: May 18, 2026
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