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Excision of a Milk Duct Fistula

Montana 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?

$646

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $646 for this service. The price depends on where it is billed: about $646 from a physician practice, and about $708 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$646$501 to $832
FacilityA hospital or hospital-owned outpatient department$708$562 to $813

How much rates vary

Facilitymedian $708 · 10th to 90th $513 to $955Professionalmedian $646 · 10th to 90th $316 to $1,778
$100$1K$10K$100Kfacility $708professional $646

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
Professional
Modifier
Global
Typical Low
$316.23
Median
$478.63
Typical High
$2,630.27
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$512.86
Typical High
$758.58
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$758.58
Typical High
$851.14
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$758.58
Typical High
$851.14
Providence
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$467.74
Typical High
$707.95
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$489.78
Typical High
$891.25
United
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$630.96
Typical High
$1,071.52

Where Montana 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.

Montana· 15th of 51

$646

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.