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Excision of a Milk Duct Fistula

Tennessee 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?

$490

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $490 for this service. The price depends on where it is billed: about $407 from a physician practice, and about $2,818 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 5 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 $537
FacilityA hospital or hospital-owned outpatient department$2,818$1,995 to $4,365

How much rates vary

Facilitymedian $2,818 · 10th to 90th $851 to $7,413Professionalmedian $407 · 10th to 90th $275 to $851
$500$1K$2K$5K$10K$20K$50Kfacility $2,818professional $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
$707.95
Median
$2,398.83
Typical High
$6,456.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$371.54
Typical High
$549.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$4,073.80
Typical High
$5,888.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$549.54
Typical High
$933.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$524.81
Typical High
$831.76
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$8,912.51
Median
$8,912.51
Typical High
$45,708.82
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$3,388.44
Median
$3,890.45
Typical High
$3,890.45
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$3,467.37
Typical High
$6,309.57
United
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$478.63
Typical High
$891.25

Where Tennessee 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.

Tennessee· 34th of 51

$490

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.