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New Mexico rates for HCPCS 30580

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

Facilitymedian $2,042 · 10th–90th $646–$20,8930%10%10th90th$2,042Professionalmedian $676 · 10th–90th $468–$1,0470%20%10th90th$676$50.0$200.0$1.0K$5.0K$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
$645.65 / $954.99 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $645.65 / $1,023.29
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $15,135.61 / $23,988.33
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $724.44 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $776.25 / $1,071.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $851.14
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $758.58 / $1,479.11
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $794.33 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $11,748.98 / $25,703.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $794.33 / $1,202.26