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North Carolina rates for HCPCS 30580

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

Facilitymedian $1,000 · 10th–90th $537–$10,4710%5%10th90th$1,000Professionalmedian $708 · 10th–90th $468–$1,5140%10%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $1,122.02 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $660.69 / $1,479.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,096.48 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $851.14 / $1,412.54
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $707.95 / $1,122.02
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $1,584.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $12,022.64 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $676.08 / $1,288.25
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $16,982.44 / $33,884.42
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $5,128.61