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Colorado 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
$1,590.56 / $3,133.00 / $10,651.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$556.42 / $694.45 / $863.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,946.00 / $9,472.00 / $17,487.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$522.79 / $685.99 / $946.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.37 / $801.92 / $1,186.92
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$579.61 / $766.73 / $1,052.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.79 / $797.19 / $1,214.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,251.00 / $11,924.00 / $19,737.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.70 / $968.40 / $1,864.00