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Hawaii rates for HCPCS 30580

Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)

Facilitymedian $5,495 · 10th–90th $1,950–$5,4950%50%10th$5,495Professionalmedian $759 · 10th–90th $490–$6,9180%10%10th90th$759$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $588.84 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $660.69 / $794.33
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $933.25 / $9,120.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $660.69 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $724.44 / $891.25
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $3,311.31 / $7,585.78