Single-vision spherocylinder eyeglass lens 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

Spherocylindr 4.00d/2.12-4d

Maple Grove, MN

See all hospitals reporting HCPCS V2104 →

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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 $56 is 2% above the median hospital's median price ($54), higher than 57% of the 732 hospitals reporting HCPCS V2104. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS V2104 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 5 payers, 18 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	$41	$41	—	—	—	$41 – $41
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$42	$42	—	—	—	$42 – $42
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$42	$42	—	—	—	$42 – $42
4	Blue Cross Blue Shield federal fee schedule · both	$45	$45	—	—	—	$45 – $45
5	Blue Cross Blue Shield commercial fee schedule · both	$46	$46	—	—	—	$46 – $46
6	Medica ma non-snp fee schedule · both	$51	$51	—	—	—	$51 – $51
7	Medica ma snp fee schedule · both	$51	$51	—	—	—	$51 – $51
8	Medica prime solution fee schedule · both	$51	$51	—	—	—	$51 – $51
9	Medica vantage fee schedule · both	$51	$51	—	—	—	$51 – $51
10	Cigna commercial fee schedule · both	$63	$63	$6	9%	—	$58 – $69
11	Ucare ifp with fairview fee schedule · outpatient	$85	$85	—	—	—	$85 – $85
12	Medica bold fee schedule · both	$89	$89	—	—	—	$89 – $89
13	UnitedHealthcare commercial fee schedule · both	$97	$97	—	—	—	$97 – $97
14	Medica choice without / elect fee schedule · both	$99	$99	—	—	—	$99 – $99
15	Medica city of st paul / essential uplan fee schedule · both	$99	$99	—	—	—	$99 – $99
16	Medica choice with fee schedule · both	$103	$103	—	—	—	$103 – $103
17	Ucare ifp fee schedule · outpatient	$114	$114	—	—	—	$114 – $114
18	Cigna commercial fee schedule · outpatient	$133	$133	$12	9%	—	$121 – $144

Last updated: May 18, 2026

Compare to other hospitals

See Single-vision spherocylinder eyeglass lens pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.