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North Dakota 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
$480.01 / $630.86 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.01 / $630.86 / $653.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$924.48 / $1,187.01 / $1,510.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$747.99 / $1,190.68 / $1,921.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$480.01 / $665.55 / $1,440.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.76 / $1,222.32 / $1,648.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.76 / $1,139.13 / $1,648.37