I switched from an HSA to an FSA but I still have a balance in my HSA. It is now being assessed a $4 maintenance fee. What is my best option here? Should I just try to spend it on eligible items?

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Probably spend it.

Sanitary products for women is probably the best use if you live with any women. First aid, contraception.

If it’s any significant amount you could transfer it to Fidelity. They don’t charge any fee (probably other brokers too)

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You can invest HSA funds…

Yes spend it or call them to get it back

You can’t “get it back”. You got tax breaks on it.
You can withdraw it and spend it on authorized expenses.
Or if you withdraw and don’t spend on authorized expenses you pay tax + a penalty.

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