Below-elbow prosthesis add-on, acrylic 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.

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Generated: October 20, 2026

Original text from hospital filings

Add UE prost b/e acrylic

Maple Grove, MN

See all hospitals reporting HCPCS L7403 →

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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 $502 is 8% above the median hospital's median price ($465), higher than 75% of the 826 hospitals reporting HCPCS L7403. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L7403 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	$381	$381	—	—	—	$381 – $381
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$388	$388	—	—	—	$388 – $388
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$388	$388	—	—	—	$388 – $388
4	Blue Cross Blue Shield federal fee schedule · both	$412	$412	—	—	—	$412 – $412
5	Blue Cross Blue Shield commercial fee schedule · both	$420	$420	—	—	—	$420 – $420
6	Medica accessability fee schedule · both	$434	$434	—	—	—	$434 – $434
7	Medica medicaid fee schedule · both	$434	$434	—	—	—	$434 – $434
8	Medica ma non-snp fee schedule · both	$471	$471	—	—	—	$471 – $471
9	Medica ma snp fee schedule · both	$471	$471	—	—	—	$471 – $471
10	Medica prime solution fee schedule · both	$471	$471	—	—	—	$471 – $471
11	Medica vantage fee schedule · both	$471	$471	—	—	—	$471 – $471
12	Blue Cross Blue Shield medicaid fee schedule · both	$473	$473	—	—	—	$473 – $473
13	Ucare mhcp fee schedule · both	$484	$484	—	—	—	$484 – $484
14	Cigna commercial fee schedule · both	$582	$582	$51	9%	—	$532 – $633
15	Ucare ifp with fairview fee schedule · outpatient	$782	$782	—	—	—	$782 – $782
16	Medica bold fee schedule · both	$819	$819	—	—	—	$819 – $819
17	UnitedHealthcare commercial fee schedule · both	$850	$850	—	—	—	$850 – $850
18	Medica choice without / elect fee schedule · both	$910	$910	—	—	—	$910 – $910
19	Medica city of st paul / essential uplan fee schedule · both	$910	$910	—	—	—	$910 – $910
20	Medica choice with fee schedule · both	$941	$941	—	—	—	$941 – $941
21	Ucare ifp fee schedule · outpatient	$1.0k	$1.0k	—	—	—	$1.0k – $1.0k
22	Cigna commercial fee schedule · outpatient	$1.2k	$1.2k	$106	9%	—	$1.1k – $1.3k

Last updated: May 18, 2026

Compare to other hospitals

See Below-elbow prosthesis add-on, acrylic material pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.