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
Anti-reflective coating
Maple Grove, MN
See all hospitals reporting HCPCS V2750 →Price type
Fairview Maple Grove Surgery Center’s median price of $28 is 8% below the median hospital's median price ($31), higher than 43% of the 739 hospitals reporting HCPCS V2750. 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 | $21 | $21 | — | — | — | $21 – $21 |
| 2 | Blue Cross Blue Shield commercial fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 3 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 4 | Blue Cross Blue Shield federal fee schedule · both | $22 | $22 | — | — | — | $22 – $22 |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $23 | $23 | — | — | — | $23 – $23 |
| 6 | Medica ma non-snp fee schedule · both | $25 | $25 | — | — | — | $25 – $25 |
| 7 | Medica ma snp fee schedule · both | $25 | $25 | — | — | — | $25 – $25 |
| 8 | Medica prime solution fee schedule · both | $25 | $25 | — | — | — | $25 – $25 |
| 9 | Medica vantage fee schedule · both | $25 | $25 | — | — | — | $25 – $25 |
| 10 | Cigna commercial fee schedule · both | $32 | $32 | $3 | 9% | — | $29 – $34 |
| 11 | Ucare ifp with fairview fee schedule · outpatient | $42 | $42 | — | — | — | $42 – $42 |
| 12 | Medica bold fee schedule · both | $44 | $44 | — | — | — | $44 – $44 |
| 13 | UnitedHealthcare commercial fee schedule · both | $49 | $49 | — | — | — | $49 – $49 |
| 14 | Medica choice without / elect fee schedule · both | $49 | $49 | — | — | — | $49 – $49 |
| 15 | Medica city of st paul / essential uplan fee schedule · both | $49 | $49 | — | — | — | $49 – $49 |
| 16 | Medica choice with fee schedule · both | $51 | $51 | — | — | — | $51 – $51 |
| 17 | Ucare ifp fee schedule · outpatient | $56 | $56 | — | — | — | $56 – $56 |
| 18 | Cigna commercial fee schedule · outpatient | $66 | $66 | $6 | 9% | — | $61 – $72 |
Last updated: May 18, 2026
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