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California rates for HCPCS 30580

Repair Fistula Oromaxillary

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$656.00 / $6,695.00 / $18,293.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.69 / $612.91 / $2,896.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,204.00 / $8,905.00 / $17,774.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$576.40 / $748.00 / $1,438.17
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $10,419.62
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.39 / $639.82 / $1,536.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,685.47 / $4,355.56 / $10,261.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.01 / $728.23 / $1,716.90
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.30 / $604.25 / $976.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.89 / $696.67 / $1,197.52
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,213.06 / $3,253.62 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,413.12 / $4,460.56 / $5,134.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$560.72 / $746.96 / $1,054.77
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.22 / $767.54 / $1,639.76
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,568.46 / $1,568.46 / $2,070.96
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.81 / $610.24 / $834.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,284.00 / $12,313.00 / $26,451.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.69 / $730.21 / $2,016.71