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Excision of a Milk Duct Fistula

Kentucky 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?

$427

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $427 for this service. The price depends on where it is billed: about $389 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 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$389$282 to $457
FacilityA hospital or hospital-owned outpatient department$3,311$1,778 to $6,761

How much rates vary

Facilitymedian $3,311 · 10th to 90th $562 to $8,511Professionalmedian $389 · 10th to 90th $269 to $676
$200$500$1K$2K$5K$10Kfacility $3,311professional $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
$302.00
Median
$616.60
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$380.19
Typical High
$812.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$3,630.78
Typical High
$8,511.38
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$380.19
Typical High
$549.54
CareSource
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$407.38
Typical High
$478.63
CareSource
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$416.87
Typical High
$489.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$537.03
Typical High
$3,388.44
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$3,467.37
Typical High
$6,456.54
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$398.11
Typical High
$776.25

Where Kentucky 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.

Kentucky· 46th of 51

$427

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.