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Illinois rates for HCPCS 42260

Repair of nasolabial fistula

Facilitymedian $3,548 · 10th–90th $1,023–$8,9130%5%10th90th$3,548Professionalmedian $912 · 10th–90th $661–$1,5490%10%10th90th$912$50.0$200.0$1.0K$5.0K$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $3,548.13 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $870.96 / $1,548.82
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $8,317.64 / $12,022.64
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $977.24 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $724.44 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $977.24 / $1,737.80
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,318.26 / $4,168.69
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $851.14 / $1,174.90
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $4,365.16 / $8,511.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $954.99 / $1,548.82