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Excision of a Milk Duct Fistula

New Hampshire 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?

$631

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $631 for this service. The price depends on where it is billed: about $631 from a physician practice, and about $3,802 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$631$468 to $871
FacilityA hospital or hospital-owned outpatient department$3,802$1,479 to $6,310

How much rates vary

Facilitymedian $3,802 · 10th to 90th $1,023 to $9,772Professionalmedian $631 · 10th to 90th $355 to $1,175
$100$200$500$1K$2K$5K$10Kfacility $3,802professional $631

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
$933.25
Median
$1,479.11
Typical High
$11,481.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$354.81
Typical High
$575.44
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$4,677.35
Typical High
$6,309.57
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$588.84
Typical High
$870.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$758.58
Typical High
$1,318.26
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$9,549.93
Median
$9,549.93
Typical High
$9,549.93
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$691.83
Typical High
$1,288.25
United
Setting
Facility
Modifier
Global
Typical Low
$9,549.93
Median
$9,549.93
Typical High
$9,549.93
United
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$676.08
Typical High
$1,348.96

Where New Hampshire 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.

New Hampshire· 18th of 51

$631

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.