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Excision of a Milk Duct Fistula

Indiana 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?

$513

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $513 for this service. The price depends on where it is billed: about $389 from a physician practice, and about $10,000 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$389$309 to $513
FacilityA hospital or hospital-owned outpatient department$10,000$4,898 to $14,791

How much rates vary

Facilitymedian $10,000 · 10th to 90th $871 to $17,783Professionalmedian $389 · 10th to 90th $263 to $676
$500$1K$2K$5K$10K$20Kfacility $10,000professional $389

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
$446.68
Median
$1,380.38
Typical High
$11,220.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$380.19
Typical High
$537.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$11,481.54
Typical High
$18,620.87
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$489.78
Typical High
$758.58
CareSource
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$323.59
Typical High
$363.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$478.63
Typical High
$776.25
United
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$5,623.41
Typical High
$10,715.19
United
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$426.58
Typical High
$691.83

Where Indiana 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.

Indiana· 29th of 51

$513

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.