go back

Excision of a Milk Duct Fistula

Arizona rates for HCPCS 19112

Surgical removal of an abnormal tunnel-like connection, called a fistula, that has formed between a milk duct and the skin near the nipple. It is done when the opening keeps draining fluid, becomes infected, or fails to heal, often after a prior breast infection or abscess. The surgeon removes the fistula tract and the affected section of duct through a small incision near the nipple or areola.

Rates data updated July 2026.

How much does Excision of a Milk Duct Fistula cost?

$468

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $468 for this service. The price depends on where it is billed: about $407 from a physician practice, and about $3,548 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$407$316 to $525
FacilityA hospital or hospital-owned outpatient department$3,548$2,188 to $4,898

How much rates vary

Facilitymedian $3,548 · 10th to 90th $575 to $7,762Professionalmedian $407 · 10th to 90th $275 to $1,778
$500$1K$2K$5Kfacility $3,548professional $407

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2,187.76
Median
$4,466.84
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$398.11
Typical High
$1,778.28
BCBS
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$2,818.38
Typical High
$5,248.07
BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$416.87
Typical High
$1,949.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,818.38
Median
$2,818.38
Typical High
$2,818.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$467.74
Typical High
$812.83
Medica
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$467.74
Typical High
$3,801.89
Medica
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$562.34
Typical High
$3,388.44
United
Setting
Facility
Modifier
Global
Typical Low
$2,187.76
Median
$3,311.31
Typical High
$5,370.32
United
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$416.87
Typical High
$741.31

Where Arizona sits

The same service costs 11.5 times more in California than in Rhode Island. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Arizona· 39th of 51

$468

CA $4,467RI $389

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.