Epicord surgical tissue patch, 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

Epicord 1 sq cm

Maple Grove, MN

See all hospitals reporting HCPCS Q4187 →

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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 $267 is 15% below the median hospital's median price ($313), higher than 40% of the 1,440 hospitals reporting HCPCS Q4187. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4187 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 5 payers, 19 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	$176	$176	—	—	—	$176 – $176
2	Medica accessability fee schedule · both	$245	$245	—	—	—	$245 – $245
3	Medica medicaid fee schedule · both	$245	$245	—	—	—	$245 – $245
4	Blue Cross Blue Shield federal fee schedule · both	$246	$246	—	—	—	$246 – $246
5	Blue Cross Blue Shield commercial fee schedule · both	$250	$250	—	—	—	$250 – $250
6	Medica ma non-snp fee schedule · both	$257	$257	—	—	—	$257 – $257
7	Medica ma snp fee schedule · both	$257	$257	—	—	—	$257 – $257
8	Medica prime solution fee schedule · both	$257	$257	—	—	—	$257 – $257
9	Medica vantage fee schedule · both	$257	$257	—	—	—	$257 – $257
10	Blue Cross Blue Shield medicaid fee schedule · both	$267	$267	—	—	—	$267 – $267
11	Ucare mhcp fee schedule · both	$269	$269	—	—	—	$269 – $269
12	Blue Cross Blue Shield federal fee schedule · outpatient	$290	$290	—	—	—	$290 – $290
13	Blue Cross Blue Shield commercial fee schedule · outpatient	$295	$295	—	—	—	$295 – $295
14	Cigna commercial fee schedule · both	$296	$296	$26	9%	—	$270 – $322
15	UnitedHealthcare commercial fee schedule · both	$444	$444	—	—	—	$444 – $444
16	Medica bold fee schedule · both	$463	$463	—	—	—	$463 – $463
17	Medica choice without / elect fee schedule · both	$515	$515	—	—	—	$515 – $515
18	Medica city of st paul / essential uplan fee schedule · both	$515	$515	—	—	—	$515 – $515
19	Medica choice with fee schedule · both	$533	$533	—	—	—	$533 – $533

Last updated: May 18, 2026

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