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Excision of a Milk Duct Fistula

Vermont 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?

$479

Typical physician fee. In Vermont, July 2026.

Insurers have agreed to pay about $479 for this service. Most negotiated rates run $324 to $479.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $479 · 10th to 90th $324 to $708
$200$500$1K$2Kprofessional $479

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
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$478.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$512.86
Typical High
$933.25
United
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$524.81
Typical High
$1,148.15

Where Vermont 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.

Vermont· 35th of 51

$479

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.