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Indiana rates for HCPCS 30580

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

Facilitymedian $14,791 · 10th–90th $1,862–$25,7040%10%10th90th$14,791Professionalmedian $603 · 10th–90th $457–$1,1750%10%20%10th90th$603$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$676.08 / $4,897.79 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $602.56 / $1,174.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $17,378.01 / $26,302.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $588.84 / $912.01
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $467.74 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $724.44 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $9,549.93 / $18,197.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $630.96 / $1,023.29