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Alaska rates for HCPCS 30580

Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)

Facilitymedian $1,259 · 10th–90th $550–$9,7720%5%10%10th90th$1,259Professionalmedian $708 · 10th–90th $479–$2,4550%10%10th90th$708$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $9,772.37 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $645.65 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $741.31 / $1,584.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $933.25 / $3,090.30
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,778.28 / $3,981.07
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,454.71 / $3,388.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $851.14 / $3,162.28
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,023.29 / $1,584.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $12,022.64 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,258.93 / $3,162.28