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Florida 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
$1,047.13 / $5,495.41 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $575.44 / $977.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $2,884.03 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $724.44 / $1,318.26
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $12,022.64 / $22,908.68
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $457.09 / $602.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $776.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $10,232.93 / $15,848.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $645.65 / $1,148.15
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $467.74 / $616.60