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.
Original text from hospital filings
Completed EPSDT
Maple Grove, MN
See all hospitals reporting HCPCS S0302 →Price type
Fairview Maple Grove Surgery Center’s median price of $90 is 61% above the median hospital's median price ($56), higher than 63% of the 185 hospitals reporting HCPCS S0302. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 9 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 | $21 | $21 | — | — | — | $21 – $21 |
| 2 | Blue Cross Blue Shield commercial fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 3 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 4 | Blue Cross Blue Shield federal fee schedule · both | $21 | $21 | — | — | — | $21 – $21 |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $22 | $22 | — | — | — | $22 – $22 |
| 6 | Medica accessability fee schedule · both | $87 | $87 | — | — | — | $87 – $87 |
| 7 | Medica medicaid fee schedule · both | $87 | $87 | — | — | — | $87 – $87 |
| 8 | Cigna commercial fee schedule · both | $109 | $109 | $10 | 9% | — | $100 – $119 |
| 9 | Medicaid medicaid fee schedule · both | $285 | $285 | — | — | — | $285 – $285 |
Last updated: May 18, 2026
See Completed children's preventive screening form (EPSDT) pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.