Single-vision eyeglass lens with high prescription power 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

Spherocylinder 4.25d/4.25-6d

Maple Grove, MN

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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 $91 is 29% above the median hospital's median price ($71), higher than 82% of the 730 hospitals reporting HCPCS V2109. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS V2109 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	$68	$68	—	—	—	$68 – $68
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$69	$69	—	—	—	$69 – $69
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$69	$69	—	—	—	$69 – $69
4	Blue Cross Blue Shield federal fee schedule · both	$74	$74	—	—	—	$74 – $74
5	Blue Cross Blue Shield commercial fee schedule · both	$75	$75	—	—	—	$75 – $75
6	Medica ma non-snp fee schedule · both	$84	$84	—	—	—	$84 – $84
7	Medica ma snp fee schedule · both	$84	$84	—	—	—	$84 – $84
8	Medica prime solution fee schedule · both	$84	$84	—	—	—	$84 – $84
9	Medica vantage fee schedule · both	$84	$84	—	—	—	$84 – $84
10	Cigna commercial fee schedule · both	$104	$104	$9	9%	—	$95 – $113
11	UnitedHealthcare commercial fee schedule · both	$127	$127	—	—	—	$127 – $127
12	Ucare ifp with fairview fee schedule · outpatient	$140	$140	—	—	—	$140 – $140
13	Medica bold fee schedule · both	$146	$146	—	—	—	$146 – $146
14	Medica choice without / elect fee schedule · both	$162	$162	—	—	—	$162 – $162
15	Medica city of st paul / essential uplan fee schedule · both	$162	$162	—	—	—	$162 – $162
16	Medica choice with fee schedule · both	$168	$168	—	—	—	$168 – $168
17	Ucare ifp fee schedule · outpatient	$186	$186	—	—	—	$186 – $186
18	Cigna commercial fee schedule · outpatient	$219	$219	$19	9%	—	$200 – $238

Last updated: May 18, 2026

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