go back

South Carolina rates for HCPCS 30580

Repair Fistula Oromaxillary

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.89 / $1,717.13 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$451.05 / $600.71 / $961.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,410.75 / $9,578.99 / $16,900.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.38 / $645.91 / $1,015.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$715.00 / $3,711.96 / $4,769.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.39 / $755.58 / $1,259.33
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$534.35 / $761.43 / $1,165.19
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.98 / $3,284.20 / $3,851.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.49 / $484.28 / $868.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $16,959.00 / $23,485.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.53 / $864.78 / $1,484.83