go back

Excision of a Milk Duct Fistula

Georgia 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?

$537

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $537 for this service. The price depends on where it is billed: about $457 from a physician practice, and about $4,169 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 6 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$457$363 to $617
FacilityA hospital or hospital-owned outpatient department$4,169$1,820 to $5,754

How much rates vary

Facilitymedian $4,169 · 10th to 90th $661 to $7,413Professionalmedian $457 · 10th to 90th $288 to $794
$500$1K$2K$5K$10K$20Kfacility $4,169professional $457

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
$436.52
Median
$4,570.88
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$426.58
Typical High
$776.25
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$3,162.28
Typical High
$6,606.93
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$512.86
Typical High
$758.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$1,949.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$537.03
Typical High
$1,023.29
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$562.34
Typical High
$776.25
United
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$3,890.45
Typical High
$6,918.31
United
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$501.19
Typical High
$870.96

Where Georgia 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.

Georgia· 26th of 51

$537

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.