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Nasolabial Fistula Repair

Colorado 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 $3,311 · 10th–90th $794$16,2180%5%10th90th$3,311Professionalmedian $891 · 10th–90th $661$1,4450%10%10th90th$891$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$891.25
Median
$5,370.32
Typical High
$8,912.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$851.14
Typical High
$1,258.93
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,165.95
Median
$11,481.54
Typical High
$19,498.45
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,071.52
Typical High
$1,621.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$891.25
Typical High
$3,311.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,000.00
Typical High
$1,548.82
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$1,000.00
Typical High
$1,548.82
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$891.25
Typical High
$3,388.44
Select Health
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$1,174.90
Typical High
$1,819.70
Select Health
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$724.44
Typical High
$1,047.13
United
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$4,897.79
Typical High
$10,471.29
United
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,023.29
Typical High
$1,621.81