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Maine rates for HCPCS 30580

Repair Fistula Oromaxillary

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.10 / $591.10 / $775.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$569.80 / $591.10 / $775.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.50 / $620.79 / $880.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$577.00 / $815.94 / $1,353.56
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.54 / $760.51 / $1,183.34
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$569.80 / $749.96 / $976.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$701.08 / $907.03 / $1,234.33