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Missouri rates for HCPCS 30580

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

Facilitymedian $4,266 · 10th–90th $1,479–$8,5110%10%10th90th$4,266Professionalmedian $631 · 10th–90th $457–$1,1750%10%10th90th$631$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
$602.56 / $4,265.80 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $616.60 / $1,174.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,570.88 / $8,317.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $660.69 / $933.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $645.65 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $707.95 / $1,230.27
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,202.26 / $26,302.68
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,000.00 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,548.13 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $691.83 / $1,096.48