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Virginia rates for HCPCS 30580

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

Facilitymedian $3,631 · 10th–90th $550–$10,9650%5%10th90th$3,631Professionalmedian $661 · 10th–90th $490–$1,1750%10%10th90th$661$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
$707.95 / $4,786.30 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $660.69 / $1,148.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $7,413.10 / $9,332.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $588.84 / $831.76
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $4,365.16 / $6,918.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $707.95 / $1,148.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $741.31 / $1,949.84
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $954.99 / $1,445.44
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $776.25 / $1,174.90
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $660.69 / $10,000.00
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $831.76 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $10,471.29 / $21,379.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $691.83 / $1,096.48