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Excision of a Milk Duct Fistula

Maine 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?

$537

Typical physician fee. In Maine, July 2026.

Insurers have agreed to pay about $537 for this service. Most negotiated rates run $407 to $724.

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 $7,943 · 10th to 90th $7,943 to $7,943Professionalmedian $537 · 10th to 90th $331 to $955
$500$1K$2K$5Kfacility $7,943professional $537

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
$251.19
Median
$331.13
Typical High
$398.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$524.81
Typical High
$812.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$575.44
Typical High
$1,023.29
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$630.96
Typical High
$977.24
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$331.13
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$7,943.28
Median
$7,943.28
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$630.96
Typical High
$1,023.29

Where Maine 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.

Maine· 25th of 51

$537

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.