Allowrap dressing, 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

Allowrap ds or dry 1 sq cm

Maple Grove, MN

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Pricing by billing methodology

Price type

How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $92 is 46% below the median hospital's median price ($170), higher than 16% of the 1,240 hospitals reporting HCPCS Q4150. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4150 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 medicaid fee schedule · outpatient	$54	$54	—	—	—	$54 – $54
2	Blue Cross Blue Shield federal fee schedule · both	$78	$78	—	—	—	$78 – $78
3	Blue Cross Blue Shield commercial fee schedule · both	$79	$79	—	—	—	$79 – $79
4	Blue Cross Blue Shield federal fee schedule · outpatient	$89	$89	—	—	—	$89 – $89
5	Blue Cross Blue Shield commercial fee schedule · outpatient	$91	$91	—	—	—	$91 – $91
6	Medica ma non-snp fee schedule · both	$92	$92	—	—	—	$92 – $92
7	Medica ma snp fee schedule · both	$92	$92	—	—	—	$92 – $92
8	Medica prime solution fee schedule · both	$92	$92	—	—	—	$92 – $92
9	Medica vantage fee schedule · both	$92	$92	—	—	—	$92 – $92
10	Cigna commercial fee schedule · both	$93	$93	$8	9%	—	$85 – $102
11	Medica bold fee schedule · both	$146	$146	—	—	—	$146 – $146
12	UnitedHealthcare commercial fee schedule · both	$156	$156	—	—	—	$156 – $156
13	Medica choice without / elect fee schedule · both	$163	$163	—	—	—	$163 – $163
14	Medica city of st paul / essential uplan fee schedule · both	$163	$163	—	—	—	$163 – $163
15	Medica choice with fee schedule · both	$168	$168	—	—	—	$168 – $168

Last updated: May 18, 2026

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