go back

Excision of a Milk Duct Fistula

Massachusetts 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?

$617

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $617 for this service. The price depends on where it is billed: about $603 from a physician practice, and about $2,188 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 8 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$603$398 to $891
FacilityA hospital or hospital-owned outpatient department$2,188$437 to $3,715

How much rates vary

Facilitymedian $2,188 · 10th to 90th $389 to $5,370Professionalmedian $603 · 10th to 90th $282 to $1,288
$500$1K$2K$5K$10K$20K$50Kfacility $2,188professional $603

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
$354.81
Median
$3,090.30
Typical High
$4,897.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$354.81
Typical High
$1,202.26
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$5,370.32
Typical High
$45,708.82
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$602.56
Typical High
$1,479.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$891.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$724.44
Typical High
$1,318.26
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$512.86
Typical High
$3,890.45
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$724.44
Typical High
$933.25
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$4,265.80
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$660.69
Typical High
$1,318.26
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$5,370.32
Typical High
$45,708.82
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$602.56
Typical High
$1,479.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$4,265.80
Typical High
$10,471.29
United
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$676.08
Typical High
$1,412.54

Where Massachusetts 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.

Massachusetts· 19th of 51

$617

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.