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Excision of a Milk Duct Fistula

Colorado 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?

$631

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $631 for this service. The price depends on where it is billed: about $447 from a physician practice, and about $6,457 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 7 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$447$331 to $562
FacilityA hospital or hospital-owned outpatient department$6,457$3,311 to $10,000

How much rates vary

Facilitymedian $6,457 · 10th to 90th $525 to $13,183Professionalmedian $447 · 10th to 90th $295 to $832
$500$1K$2K$5K$10K$20Kfacility $6,457professional $447

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
$467.74
Median
$5,495.41
Typical High
$8,912.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$398.11
Typical High
$812.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,786.30
Median
$9,549.93
Typical High
$15,135.61
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$549.54
Typical High
$870.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$575.44
Typical High
$891.25
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$512.86
Typical High
$724.44
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$724.44
Typical High
$2,089.30
Select Health
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$676.08
Typical High
$1,096.48
Select Health
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$331.13
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$5,011.87
Typical High
$10,471.29
United
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$549.54
Typical High
$912.01

Where Colorado 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.

Colorado· 17th of 51

$631

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.