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Excision of a Milk Duct Fistula

Maryland 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?

$398

Typical physician fee. In Maryland, July 2026.

Insurers have agreed to pay about $398 for this service. Most negotiated rates run $331 to $513.

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.

How much rates vary

Facilitymedian $1,622 · 10th to 90th $1,622 to $7,943Professionalmedian $398 · 10th to 90th $275 to $1,288
$500$1K$2K$5Kfacility $1,622professional $398

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$398.11
Typical High
$1,778.28
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$1,621.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$512.86
Typical High
$1,047.13
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$616.60
Typical High
$870.96
United
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$467.74
Typical High
$870.96
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$691.83
Typical High
$776.25

Where Maryland 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.

Maryland· 49th of 51

$398

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.