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Nasolabial Fistula Repair

Iowa 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 $4,266 · 10th–90th $912$10,9650%5%10th90th$4,266Professionalmedian $1,096 · 10th–90th $661$3,7150%10%10th90th$1,096$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
$1,148.15
Median
$5,011.87
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$912.01
Typical High
$3,715.35
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7,244.36
Median
$7,244.36
Typical High
$7,244.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,548.82
Typical High
$2,511.89
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$1,288.25
Typical High
$3,162.28
Medica
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,479.11
Typical High
$8,317.64
Medica
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,737.80
Typical High
$6,456.54
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$1,778.28
Typical High
$2,290.87
Midlands
Setting
Facility
Modifier
Global
Typical Low
$7,244.36
Median
$7,244.36
Typical High
$7,244.36
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,659.59
Typical High
$2,398.83
United
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$7,413.10
Typical High
$15,488.17
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,122.02
Typical High
$2,089.30
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,445.44
Typical High
$2,089.30