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Illinois rates for HCPCS 30580

Repair Fistula Oromaxillary

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.66 / $1,175.84 / $5,430.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409.21 / $658.71 / $1,148.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.52 / $7,831.58 / $11,469.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.11 / $861.31 / $1,111.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $875.00 / $908.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.39 / $787.26 / $1,196.64
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$581.41 / $890.26 / $1,940.44
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559.55 / $578.66 / $818.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $944.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,300.00 / $5,978.00 / $12,241.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$634.54 / $851.82 / $1,416.01