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Excision of a Milk Duct Fistula

New Mexico 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?

$537

Typical negotiated rate. In New Mexico, July 2026.

Insurers have agreed to pay about $537 for this service. The price depends on where it is billed: about $457 from a physician practice, and about $4,169 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$457$363 to $646
FacilityA hospital or hospital-owned outpatient department$4,169$759 to $8,913

How much rates vary

Facilitymedian $4,169 · 10th to 90th $479 to $12,882Professionalmedian $457 · 10th to 90th $245 to $1,778
$50$200$1K$5Kfacility $4,169professional $457

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
$512.86
Median
$794.33
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$457.09
Typical High
$1,778.28
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$8,912.51
Typical High
$14,125.38
BCBS
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$501.19
Typical High
$691.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$512.86
Typical High
$812.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$645.65
Providence
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$489.78
Typical High
$1,023.29
Providence
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$549.54
Typical High
$812.83
United
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$6,918.31
Typical High
$16,982.44
United
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$524.81
Typical High
$794.33

Where New Mexico 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 Mexico· 24th of 51

$537

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.