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
Lens sphcy trifocal 4.0/4.25
Maple Grove, MN
See all hospitals reporting HCPCS V2305 →Price type
Fairview Maple Grove Surgery Center’s median price of $109 is 2% below the median hospital's median price ($112), higher than 42% of the 727 hospitals reporting HCPCS V2305. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
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 | $80 | $80 | — | — | — | $80 – $80 |
| 2 | Blue Cross Blue Shield commercial fee schedule · outpatient | $82 | $82 | — | — | — | $82 – $82 |
| 3 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $82 | $82 | — | — | — | $82 – $82 |
| 4 | Blue Cross Blue Shield federal fee schedule · both | $87 | $87 | — | — | — | $87 – $87 |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $88 | $88 | — | — | — | $88 – $88 |
| 6 | Medica ma non-snp fee schedule · both | $99 | $99 | — | — | — | $99 – $99 |
| 7 | Medica ma snp fee schedule · both | $99 | $99 | — | — | — | $99 – $99 |
| 8 | Medica prime solution fee schedule · both | $99 | $99 | — | — | — | $99 – $99 |
| 9 | Medica vantage fee schedule · both | $99 | $99 | — | — | — | $99 – $99 |
| 10 | Cigna commercial fee schedule · both | $122 | $122 | $11 | 9% | — | $112 – $133 |
| 11 | Ucare ifp with fairview fee schedule · outpatient | $164 | $164 | — | — | — | $164 – $164 |
| 12 | Medica bold fee schedule · both | $172 | $172 | — | — | — | $172 – $172 |
| 13 | Medica choice without / elect fee schedule · both | $191 | $191 | — | — | — | $191 – $191 |
| 14 | Medica city of st paul / essential uplan fee schedule · both | $191 | $191 | — | — | — | $191 – $191 |
| 15 | Medica choice with fee schedule · both | $198 | $198 | — | — | — | $198 – $198 |
| 16 | UnitedHealthcare commercial fee schedule · both | $200 | $200 | — | — | — | $200 – $200 |
| 17 | Ucare ifp fee schedule · outpatient | $219 | $219 | — | — | — | $219 – $219 |
| 18 | Cigna commercial fee schedule · outpatient | $257 | $257 | $22 | 9% | — | $235 – $280 |
Last updated: May 18, 2026
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