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Excision of a Milk Duct Fistula

Michigan 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?

$457

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $457 for this service. The price depends on where it is billed: about $427 from a physician practice, and about $4,074 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$427$331 to $537
FacilityA hospital or hospital-owned outpatient department$4,074$4,074 to $4,898

How much rates vary

Facilitymedian $4,074 · 10th to 90th $537 to $6,918Professionalmedian $427 · 10th to 90th $282 to $759
$500$1K$2K$5K$10Kfacility $4,074professional $427

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
$537.03
Median
$4,073.80
Typical High
$5,754.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$380.19
Typical High
$537.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$758.58
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$489.78
Typical High
$831.76
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$4,073.80
Typical High
$5,754.40
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$489.78
Typical High
$645.65
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
United
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$5,248.07
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$457.09
Typical High
$691.83

Where Michigan 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.

Michigan· 42nd of 51

$457

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.