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
Adult size pull-on xl
Maple Grove, MN
See all hospitals reporting HCPCS T4528 →Price type
Fairview Maple Grove Surgery Center’s median price of $1 is 19% above the median hospital's median price ($1), higher than 63% of the 196 hospitals reporting HCPCS T4528. 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, 12 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 | Ucare ifp with fairview fee schedule · both | $1 | $1 | — | — | — | $1 – $1 |
| 2 | Blue Cross Blue Shield federal fee schedule · both | $1 | $1 | — | — | — | $1 – $1 |
| 3 | Blue Cross Blue Shield federal fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 4 | Medica accessability fee schedule · both | $1 | $1 | — | — | — | $1 – $1 |
| 5 | Medica medicaid fee schedule · both | $1 | $1 | — | — | — | $1 – $1 |
| 6 | Blue Cross Blue Shield commercial fee schedule · both | $1 | $1 | — | — | — | $1 – $1 |
| 7 | Blue Cross Blue Shield commercial fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 8 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 9 | Ucare ifp fee schedule · both | $1 | $1 | — | — | — | $1 – $1 |
| 10 | Blue Cross Blue Shield medicaid fee schedule · both | $1 | $1 | — | — | — | $1 – $1 |
| 11 | Ucare mhcp fee schedule · both | $1 | $1 | — | — | — | $1 – $1 |
| 12 | Cigna commercial fee schedule · both | $2 | $2 | $0 | 9% | — | $2 – $2 |
Last updated: May 18, 2026
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