go back

Maine rates for HCPCS 30580

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

Facilitymedian $776 · 10th–90th $589–$12,0230%20%10th90th$776Professionalmedian $708 · 10th–90th $513–$1,1750%10%20%10th90th$708$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $707.95 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $676.08 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $776.25 / $1,380.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $776.25 / $1,202.26
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $691.83 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $12,022.64 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $812.83 / $1,258.93