go back

Excision of a Milk Duct Fistula

Washington, DC 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?

$490

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $490 for this service. Most negotiated rates run $331 to $1,318.

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.

How much rates vary

Facilitymedian $4,074 · 10th to 90th $331 to $7,762Professionalmedian $468 · 10th to 90th $331 to $603
$500$1K$2K$5K$10K$20Kfacility $4,074professional $468

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
$331.13
Median
$3,981.07
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$354.81
Typical High
$489.78
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$2,570.40
Typical High
$6,456.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$489.78
Typical High
$1,318.26
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$575.44
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$10,000.00
Typical High
$26,302.68
United
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$630.96
Typical High
$1,096.48

Where Washington, DC 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.

Washington, DC· 32nd of 51

$490

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.