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Nasolabial Fistula Repair

Illinois 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 $2,630 · 10th–90th $871$9,7720%5%10th90th$2,630Professionalmedian $891 · 10th–90th $661$1,5490%10%10th90th$891$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
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$2,089.30
Typical High
$8,912.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$851.14
Typical High
$1,479.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,265.80
Median
$8,317.64
Typical High
$12,022.64
BCBS
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,000.00
Typical High
$1,548.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$724.44
Typical High
$5,623.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$977.24
Typical High
$1,698.24
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,318.26
Typical High
$4,168.69
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$851.14
Typical High
$1,174.90
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,148.15
United
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$4,365.16
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$954.99
Typical High
$1,584.89