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Nasolabial Fistula Repair

Nationwide rates for HCPCS 42260

Surgically closes a nasolabial fistula -- an abnormal opening connecting the nose and the mouth near the upper lip. This is most often needed as a later repair following an earlier cleft lip or palate procedure.

Rates data updated July 2026.

Facilitymedian $3,802 · 10th–90th $813$13,1830%10%10th90th$3,802Professionalmedian $891 · 10th–90th $646$1,9050%50%10th90th$891$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$4,073.80
Typical High
$11,481.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$851.14
Typical High
$1,348.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$8,511.38
Typical High
$17,378.01
BCBS
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$870.96
Typical High
$1,621.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$2,630.27
Typical High
$7,079.46
Cigna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$1,000.00
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$4,265.80
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$933.25
Typical High
$1,778.28