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Excision of a Milk Duct Fistula

Rhode Island 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?

$389

Typical physician fee. In Rhode Island, July 2026.

Insurers have agreed to pay about $389 for this service. Most negotiated rates run $316 to $537.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $3,715 · 10th to 90th $2,570 to $8,710Professionalmedian $380 · 10th to 90th $234 to $724
$500$1K$2K$5K$10Kfacility $3,715professional $380

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$3,235.94
Typical High
$3,981.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$354.81
Typical High
$616.60
BCBS
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$457.09
Typical High
$758.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$524.81
Typical High
$776.25
United
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$4,677.35
Typical High
$8,709.64
United
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$446.68
Typical High
$758.58

Where Rhode Island 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.

Rhode Island· 51st of 51

$389

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.