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Texas rates for HCPCS 30580

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

Facilitymedian $3,981 · 10th–90th $724$14,1250%5%10%10th90th$3,981Professionalmedian $631 · 10th–90th $457$1,0000%20%10th90th$631$10.0$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
$977.24 / $3,715.35 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $630.96 / $933.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $7,585.78 / $14,791.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $588.84 / $912.01
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $724.44 / $1,202.26
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $33,884.42 / $33,884.42
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $5,128.61 / $5,128.61
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $831.76 / $4,265.80
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $707.95 / $1,148.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $389.05
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $1,318.26 / $1,621.81
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $724.44 / $1,288.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $724.44 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $6,165.95 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $616.60 / $977.24
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $630.96 / $630.96