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
Glass/plastic slab off prism
Maple Grove, MN
See all hospitals reporting HCPCS V2710 →Price type
Fairview Maple Grove Surgery Center’s median price of $103 is 10% above the median hospital's median price ($94), higher than 75% of the 717 hospitals reporting HCPCS V2710. 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 | $76 | $76 | — | — | — | $76 – $76 |
| 2 | Blue Cross Blue Shield commercial fee schedule · outpatient | $77 | $77 | — | — | — | $77 – $77 |
| 3 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $77 | $77 | — | — | — | $77 – $77 |
| 4 | Blue Cross Blue Shield federal fee schedule · both | $82 | $82 | — | — | — | $82 – $82 |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $83 | $83 | — | — | — | $83 – $83 |
| 6 | Medica ma non-snp fee schedule · both | $94 | $94 | — | — | — | $94 – $94 |
| 7 | Medica ma snp fee schedule · both | $94 | $94 | — | — | — | $94 – $94 |
| 8 | Medica prime solution fee schedule · both | $94 | $94 | — | — | — | $94 – $94 |
| 9 | Medica vantage fee schedule · both | $94 | $94 | — | — | — | $94 – $94 |
| 10 | Cigna commercial fee schedule · both | $115 | $115 | $10 | 9% | — | $105 – $126 |
| 11 | Ucare ifp with fairview fee schedule · outpatient | $155 | $155 | — | — | — | $155 – $155 |
| 12 | Medica bold fee schedule · both | $162 | $162 | — | — | — | $162 – $162 |
| 13 | UnitedHealthcare commercial fee schedule · both | $165 | $165 | — | — | — | $165 – $165 |
| 14 | Medica choice without / elect fee schedule · both | $181 | $181 | — | — | — | $181 – $181 |
| 15 | Medica city of st paul / essential uplan fee schedule · both | $181 | $181 | — | — | — | $181 – $181 |
| 16 | Medica choice with fee schedule · both | $187 | $187 | — | — | — | $187 – $187 |
| 17 | Ucare ifp fee schedule · outpatient | $207 | $207 | — | — | — | $207 – $207 |
| 18 | Cigna commercial fee schedule · outpatient | $242 | $242 | $21 | 9% | — | $221 – $264 |
Last updated: May 18, 2026
See Glass or plastic prism lens, per lens pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.