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Arizona rates for HCPCS 30580

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

Facilitymedian $4,571 · 10th–90th $977–$7,9430%10%10th90th$4,571Professionalmedian $631 · 10th–90th $468–$1,4130%10%10th90th$631$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$2,137.96 / $4,677.35 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $630.96 / $1,412.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $3,388.44 / $6,456.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $537.03 / $2,454.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $660.69 / $1,202.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $741.31 / $7,079.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $794.33 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $5,495.41 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $602.56 / $1,023.29