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Excision of a Milk Duct Fistula

Oregon 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?

$794

Typical negotiated rate. In Oregon, July 2026.

Insurers have agreed to pay about $794 for this service. The price depends on where it is billed: about $776 from a physician practice, and about $891 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 8 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$776$562 to $1,023
FacilityA hospital or hospital-owned outpatient department$891$661 to $955

How much rates vary

Facilitymedian $891 · 10th to 90th $457 to $8,318Professionalmedian $776 · 10th to 90th $447 to $1,259
$100$500$2K$10Kfacility $891professional $776

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
$812.83
Median
$1,174.90
Typical High
$17,378.01
Aetna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$776.25
Typical High
$1,778.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$812.83
Typical High
$1,230.27
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$851.14
Typical High
$1,202.26
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$630.96
Typical High
$1,047.13
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$758.58
Typical High
$1,174.90
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$891.25
Typical High
$891.25
Providence
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$630.96
Typical High
$1,071.52
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$776.25
Typical High
$1,174.90
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$9,120.11
Median
$12,589.25
Typical High
$15,135.61
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$891.25
Typical High
$1,258.93
United
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$9,549.93
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$794.33
Typical High
$1,230.27

Where Oregon 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.

Oregon· 9th of 51

$794

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.