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Excision of a Milk Duct Fistula

Kansas 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 Kansas, July 2026.

Insurers have agreed to pay about $468 for this service. The price depends on where it is billed: about $417 from a physician practice, and about $3,311 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$417$339 to $589
FacilityA hospital or hospital-owned outpatient department$3,311$1,950 to $6,457

How much rates vary

Facilitymedian $3,311 · 10th to 90th $468 to $8,511Professionalmedian $417 · 10th to 90th $288 to $631
$500$1K$2K$5K$10K$20Kfacility $3,311professional $417

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
$489.78
Median
$3,630.78
Typical High
$9,120.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$407.38
Typical High
$630.96
BCBS
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$588.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$489.78
Typical High
$812.83
Medica
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$588.84
Typical High
$6,456.54
Medica
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$588.84
Typical High
$3,388.44
United
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$2,884.03
Typical High
$5,623.41
United
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$457.09
Typical High
$724.44

Where Kansas 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.

Kansas· 38th 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.