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Maryland rates for HCPCS 30580

Repair Fistula Oromaxillary

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$497.56 / $664.79 / $2,527.80
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.91 / $496.16 / $567.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,076.35 / $3,076.35 / $3,076.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.71 / $753.86 / $1,408.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.74 / $820.10 / $1,411.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$547.94 / $716.92 / $1,249.90
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$522.66 / $731.10 / $906.69