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Georgia 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
$683.08 / $4,592.00 / $6,915.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$465.98 / $683.08 / $1,427.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,376.26 / $3,839.45 / $8,545.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.28 / $681.98 / $1,198.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,685.16 / $3,685.16 / $3,685.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$561.07 / $916.81 / $1,420.35
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.81 / $688.48 / $1,399.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,738.00 / $7,794.00 / $14,048.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.46 / $853.89 / $1,491.48