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Tennessee rates for HCPCS 30580

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

Facilitymedian $3,981 · 10th–90th $1,096–$8,9130%10%10th90th$3,981Professionalmedian $646 · 10th–90th $457–$1,1750%10%20%10th90th$646$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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
$1,047.13 / $2,454.71 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $602.56 / $1,071.52
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $6,606.93 / $9,772.37
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $812.83 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $3,801.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $707.95 / $1,148.15
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $16,982.44 / $33,884.42
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $5,128.61 / $5,128.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $5,754.40 / $10,232.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $741.31 / $1,230.27