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Excision of a Milk Duct Fistula

South Dakota 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?

$661

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $661 for this service. The price depends on where it is billed: about $661 from a physician practice, and about $759 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 7 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$661$447 to $891
FacilityA hospital or hospital-owned outpatient department$759$468 to $3,548

How much rates vary

Facilitymedian $759 · 10th to 90th $389 to $4,365Professionalmedian $661 · 10th to 90th $309 to $1,047
$500$1K$2K$5Kfacility $759professional $661

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
$309.03
Median
$3,548.13
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$389.05
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$933.25
Typical High
$1,318.26
Medica
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$602.56
Typical High
$1,174.90
Medica
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$891.25
Typical High
$3,388.44
Midlands
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$724.44
Typical High
$1,023.29
Midlands
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$645.65
Typical High
$933.25
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$676.08
Typical High
$891.25
United
Setting
Facility
Modifier
Global
Typical Low
$2,691.53
Median
$2,691.53
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$691.83
Typical High
$1,230.27
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$758.58
Typical High
$1,148.15

Where South Dakota 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 Dakota· 14th of 51

$661

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.