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Connecticut 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
$1,174.90 / $5,888.44 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $660.69 / $1,412.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $15,135.61 / $16,595.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $891.25 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $891.25 / $1,412.54
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,258.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $10,471.29 / $16,218.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $758.58 / $1,479.11