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Mississippi rates for HCPCS 30580

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.32 / $1,155.74 / $1,836.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.31 / $1,031.15 / $1,521.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,920.52 / $2,920.52 / $2,920.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,044.00 / $1,044.00 / $1,044.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,018.06 / $3,018.06 / $6,486.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$479.55 / $740.99 / $1,182.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$985.00 / $3,428.00 / $9,302.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572.94 / $738.30 / $1,527.51