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Arkansas rates for HCPCS 30580

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$649.78 / $1,277.00 / $9,034.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.89 / $649.78 / $818.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,430.62 / $5,430.62 / $6,516.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$465.42 / $616.00 / $807.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,337.37 / $4,337.37 / $4,337.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.41 / $867.01 / $1,106.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,565.00 / $2,828.00 / $6,957.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$525.61 / $662.04 / $1,160.25