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Excision of a Milk Duct Fistula

North Dakota 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?

$724

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $724 for this service. The price depends on where it is billed: about $759 from a physician practice, and about $447 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 5 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$759$479 to $912
FacilityA hospital or hospital-owned outpatient department$447$309 to $457

How much rates vary

Facilitymedian $447 · 10th to 90th $309 to $5,129Professionalmedian $759 · 10th to 90th $309 to $1,072
$500$1K$2K$5Kfacility $447professional $759

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
$309.03
Median
$446.68
Typical High
$5,011.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$446.68
Typical High
$457.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$851.14
Typical High
$1,096.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$758.58
Typical High
$1,122.02
Medica
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$457.09
Typical High
$933.25
Medica
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$812.83
Typical High
$1,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$5,128.61
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$602.56
Typical High
$1,047.13

Where North Dakota 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.

North Dakota· 12th of 51

$724

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.