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Oklahoma 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
$1,000.00 / $2,630.27 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $588.84 / $1,000.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,309.57 / $9,772.37 / $15,488.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $741.31 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $660.69 / $891.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $1,288.25 / $8,912.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $724.44 / $4,570.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $5,754.40 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $575.44 / $851.14