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Nasolabial Fistula Repair

Arizona 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?

$851

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $851 for this service. The price depends on where it is billed: about $832 from a physician practice, and about $3,090 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$832$708 to $1,000
FacilityA hospital or hospital-owned outpatient department$3,090$977 to $4,786

How much rates vary

Facilitymedian $3,090 · 10th to 90th $759 to $6,918Professionalmedian $832 · 10th to 90th $631 to $1,445
$500.0$1.0K$2.0K$5.0K$10.0K$20.0Kfacility $3,090professional $832

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
$4,677.35
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$794.33
Typical High
$1,318.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$3,235.94
Typical High
$6,309.57
BCBS
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,023.29
Typical High
$1,819.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$3,311.31
Typical High
$5,370.32
Cigna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$870.96
Typical High
$1,584.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$891.25
Typical High
$1,949.84
Medica
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,148.15
Typical High
$6,456.54
United
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$3,388.44
Typical High
$5,370.32
United
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$812.83
Typical High
$1,412.54

Where Arizona 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.

Arizona $851 · 41st 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.