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Wyoming rates for HCPCS 30580

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466.61 / $466.61 / $627.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$838.00 / $1,109.00 / $1,618.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.48 / $881.16 / $1,510.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,188.00 / $5,188.00 / $18,767.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$701.08 / $1,530.51 / $2,482.92