Alloskin acellular dermal matrix, per square centimeter 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

Alloskin ac, 1 cm

Maple Grove, MN

See all hospitals reporting HCPCS Q4141 →

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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 $73 is 41% below the median hospital's median price ($124), higher than 25% of the 931 hospitals reporting HCPCS Q4141. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4141 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 4 payers, 15 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 · both	$39	$39	—	—	—	$39 – $39
2	Blue Cross Blue Shield commercial fee schedule · both	$40	$40	—	—	—	$40 – $40
3	Medica ma non-snp fee schedule · both	$40	$40	—	—	—	$40 – $40
4	Medica ma snp fee schedule · both	$40	$40	—	—	—	$40 – $40
5	Medica prime solution fee schedule · both	$40	$40	—	—	—	$40 – $40
6	Medica vantage fee schedule · both	$40	$40	—	—	—	$40 – $40
7	Cigna commercial fee schedule · both	$49	$49	$4	9%	—	$45 – $54
8	Blue Cross Blue Shield medicaid fee schedule · outpatient	$72	$72	—	—	—	$72 – $72
9	Medica bold fee schedule · both	$74	$74	—	—	—	$74 – $74
10	Medica choice without / elect fee schedule · both	$83	$83	—	—	—	$83 – $83
11	Medica city of st paul / essential uplan fee schedule · both	$83	$83	—	—	—	$83 – $83
12	Medica choice with fee schedule · both	$86	$86	—	—	—	$86 – $86
13	Blue Cross Blue Shield federal fee schedule · outpatient	$119	$119	—	—	—	$119 – $119
14	Blue Cross Blue Shield commercial fee schedule · outpatient	$121	$121	—	—	—	$121 – $121
15	UnitedHealthcare commercial fee schedule · both	$174	$174	—	—	—	$174 – $174

Last updated: May 18, 2026

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