Bifocal eyeglass lens with sphere and cylinder correction 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

Lens sphcy bifocal 4.00d/2.1

Maple Grove, MN

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $76 is 5% above the median hospital's median price ($73), higher than 62% of the 732 hospitals reporting HCPCS V2204. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS V2204 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	$57	$57	—	—	—	$57 – $57
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$58	$58	—	—	—	$58 – $58
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$58	$58	—	—	—	$58 – $58
4	Blue Cross Blue Shield federal fee schedule · both	$62	$62	—	—	—	$62 – $62
5	Blue Cross Blue Shield commercial fee schedule · both	$63	$63	—	—	—	$63 – $63
6	Medica ma non-snp fee schedule · both	$71	$71	—	—	—	$71 – $71
7	Medica ma snp fee schedule · both	$71	$71	—	—	—	$71 – $71
8	Medica prime solution fee schedule · both	$71	$71	—	—	—	$71 – $71
9	Medica vantage fee schedule · both	$71	$71	—	—	—	$71 – $71
10	Cigna commercial fee schedule · both	$87	$87	$8	9%	—	$80 – $95
11	Ucare ifp with fairview fee schedule · outpatient	$117	$117	—	—	—	$117 – $117
12	Medica bold fee schedule · both	$123	$123	—	—	—	$123 – $123
13	Medica choice without / elect fee schedule · both	$136	$136	—	—	—	$136 – $136
14	Medica city of st paul / essential uplan fee schedule · both	$136	$136	—	—	—	$136 – $136
15	UnitedHealthcare commercial fee schedule · both	$139	$139	—	—	—	$139 – $139
16	Medica choice with fee schedule · both	$141	$141	—	—	—	$141 – $141
17	Ucare ifp fee schedule · outpatient	$156	$156	—	—	—	$156 – $156
18	Cigna commercial fee schedule · outpatient	$183	$183	$16	9%	—	$168 – $199

Last updated: May 18, 2026

Compare to other hospitals

See Bifocal eyeglass lens with sphere and cylinder correction pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.