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Excision of a Milk Duct Fistula

Missouri 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?

$589

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $589 for this service. The price depends on where it is billed: about $407 from a physician practice, and about $2,291 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$407$309 to $562
FacilityA hospital or hospital-owned outpatient department$2,291$1,259 to $3,548

How much rates vary

Facilitymedian $2,291 · 10th to 90th $407 to $5,623Professionalmedian $407 · 10th to 90th $275 to $871
$500$1K$2K$5K$10Kfacility $2,291professional $407

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
$338.84
Median
$3,162.28
Typical High
$7,413.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$389.05
Typical High
$2,511.89
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,778.28
Typical High
$3,981.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$407.38
Typical High
$691.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$501.19
Typical High
$645.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$489.78
Typical High
$891.25
Medica
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$741.31
Typical High
$26,302.68
Medica
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$676.08
Typical High
$3,388.44
United
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$3,019.95
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$446.68
Typical High
$758.58

Where Missouri 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.

Missouri· 21st of 51

$589

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.