Amnioband placental tissue graft, per milligram 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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Amnioband, 1 mg

Maple Grove, MN

See all hospitals reporting HCPCS Q4168 →

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $19 is 40% below the median hospital's median price ($32), higher than 23% of the 740 hospitals reporting HCPCS Q4168. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4168 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 4 payers, 13 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	Medica ma non-snp fee schedule · both	$18	$18	—	—	—	$18 – $18
2	Medica ma snp fee schedule · both	$18	$18	—	—	—	$18 – $18
3	Medica prime solution fee schedule · both	$18	$18	—	—	—	$18 – $18
4	Medica vantage fee schedule · both	$18	$18	—	—	—	$18 – $18
5	Cigna commercial fee schedule · both	$20	$20	$2	9%	—	$19 – $22
6	UnitedHealthcare commercial fee schedule · both	$31	$31	—	—	—	$31 – $31
7	Medica bold fee schedule · both	$33	$33	—	—	—	$33 – $33
8	Medica choice without / elect fee schedule · both	$36	$36	—	—	—	$36 – $36
9	Medica city of st paul / essential uplan fee schedule · both	$36	$36	—	—	—	$36 – $36
10	Medica choice with fee schedule · both	$37	$37	—	—	—	$37 – $37
11	Blue Cross Blue Shield medicaid fee schedule · outpatient	$211	$211	—	—	—	$211 – $211
12	Blue Cross Blue Shield federal fee schedule · outpatient	$348	$348	—	—	—	$348 – $348
13	Blue Cross Blue Shield commercial fee schedule · outpatient	$354	$354	—	—	—	$354 – $354

Last updated: May 18, 2026

Compare to other hospitals

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