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Excision of a Milk Duct Fistula

South Carolina 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?

$457

Typical negotiated rate. In South Carolina, July 2026.

Insurers have agreed to pay about $457 for this service. The price depends on where it is billed: about $407 from a physician practice, and about $5,623 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$407$331 to $490
FacilityA hospital or hospital-owned outpatient department$5,623$550 to $11,749

How much rates vary

Facilitymedian $5,623 · 10th to 90th $355 to $20,417Professionalmedian $407 · 10th to 90th $316 to $661
$50$200$1K$5K$20Kfacility $5,623professional $407

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
$346.74
Median
$9,772.37
Typical High
$21,877.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$407.38
Typical High
$588.84
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$5,888.44
Typical High
$10,000.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$436.52
Typical High
$660.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$2,511.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$501.19
Typical High
$933.25
Medcost
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$489.78
Typical High
$1,000.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$10,715.19
Typical High
$16,982.44
United
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$436.52
Typical High
$776.25

Where South Carolina 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.

South Carolina· 41st of 51

$457

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.