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New Hampshire rates for HCPCS 30580

Repair Fistula Oromaxillary

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,220.86 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.77 / $518.42 / $1,772.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,769.10 / $5,299.00 / $8,600.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$479.70 / $786.42 / $1,102.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$657.13 / $1,186.23 / $1,852.63
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.22 / $1,126.26 / $2,108.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,155.00 / $11,155.00 / $11,155.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$792.12 / $1,096.55 / $2,122.91
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$412.80 / $545.86 / $858.85