go back

New Jersey 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
$4,365.16 / $7,244.36 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $616.60 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $794.33 / $1,905.46
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $794.33 / $1,174.90
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $19,054.61 / $30,199.52
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $724.44 / $1,412.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $9,120.11 / $21,379.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $562.34 / $1,174.90