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Nasolabial Fistula Repair

Alaska 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.

How much does Nasolabial Fistula Repair cost?

$1,660

Typical negotiated rate. In Alaska, July 2026.

Insurers have agreed to pay about $1,660 for this service. The price depends on where it is billed: about $1,820 from a physician practice, and about $1,096 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$1,820$851 to $3,388
FacilityA hospital or hospital-owned outpatient department$1,096$871 to $1,585

How much rates vary

Facilitymedian $1,096 · 10th to 90th $741 to $3,548Professionalmedian $1,820 · 10th to 90th $692 to $4,467
$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0Kfacility $1,096professional $1,820

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
$2,187.76
Median
$12,022.64
Typical High
$14,125.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$851.14
Typical High
$3,548.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$954.99
Typical High
$2,187.76
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$1,071.52
Typical High
$2,041.74
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$2,570.40
Typical High
$5,011.87
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,137.96
Median
$3,548.13
Typical High
$4,570.88
Providence
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$1,071.52
Typical High
$2,041.74
Providence
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$1,479.11
Typical High
$2,187.76
United
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$12,022.64
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$933.25
Typical High
$3,630.78

Where Alaska sits

The same service costs 2.2 times more in Minnesota than in West Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Alaska $1,660 · 2nd of 51
MN $1,738WV $794

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.