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
Interscap-thor myoelectronic
Maple Grove, MN
See all hospitals reporting HCPCS L6975 →Price type
Fairview Maple Grove Surgery Center’s median price of $23.9k is 6% above the median hospital's median price ($22.7k), higher than 65% of the 812 hospitals reporting HCPCS L6975. 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 | $18.3k | $18.3k | — | — | — | $18.3k – $18.3k |
| 2 | Blue Cross Blue Shield commercial fee schedule · outpatient | $18.7k | $18.7k | — | — | — | $18.7k – $18.7k |
| 3 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $18.7k | $18.7k | — | — | — | $18.7k – $18.7k |
| 4 | Blue Cross Blue Shield federal fee schedule · both | $19.9k | $19.9k | — | — | — | $19.9k – $19.9k |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $20.2k | $20.2k | — | — | — | $20.2k – $20.2k |
| 6 | Medica accessability fee schedule · both | $20.9k | $20.9k | — | — | — | $20.9k – $20.9k |
| 7 | Medica medicaid fee schedule · both | $20.9k | $20.9k | — | — | — | $20.9k – $20.9k |
| 8 | Medica ma non-snp fee schedule · both | $22.7k | $22.7k | — | — | — | $22.7k – $22.7k |
| 9 | Medica ma snp fee schedule · both | $22.7k | $22.7k | — | — | — | $22.7k – $22.7k |
| 10 | Medica prime solution fee schedule · both | $22.7k | $22.7k | — | — | — | $22.7k – $22.7k |
| 11 | Medica vantage fee schedule · both | $22.7k | $22.7k | — | — | — | $22.7k – $22.7k |
| 12 | Blue Cross Blue Shield medicaid fee schedule · both | $22.8k | $22.8k | — | — | — | $22.8k – $22.8k |
| 13 | Ucare mhcp fee schedule · both | $23.3k | $23.3k | — | — | — | $23.3k – $23.3k |
| 14 | Cigna commercial fee schedule · both | $28.0k | $28.0k | $2.4k | 9% | — | $25.6k – $30.5k |
| 15 | Ucare ifp with fairview fee schedule · outpatient | $37.6k | $37.6k | — | — | — | $37.6k – $37.6k |
| 16 | Medica bold fee schedule · both | $39.4k | $39.4k | — | — | — | $39.4k – $39.4k |
| 17 | UnitedHealthcare commercial fee schedule · both | $41.1k | $41.1k | — | — | — | $41.1k – $41.1k |
| 18 | Medica choice without / elect fee schedule · both | $43.8k | $43.8k | — | — | — | $43.8k – $43.8k |
| 19 | Medica city of st paul / essential uplan fee schedule · both | $43.8k | $43.8k | — | — | — | $43.8k – $43.8k |
| 20 | Medica choice with fee schedule · both | $45.3k | $45.3k | — | — | — | $45.3k – $45.3k |
| 21 | Ucare ifp fee schedule · outpatient | $50.2k | $50.2k | — | — | — | $50.2k – $50.2k |
| 22 | Cigna commercial fee schedule · outpatient | $58.9k | $58.9k | $5.1k | 9% | — | $53.7k – $64.0k |
Last updated: May 18, 2026
See Upper-limb prosthesis: powered shoulder-to-hand arm with removable shell pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.