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Nasolabial Fistula Repair

Louisiana 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?

$933

Typical negotiated rate. In Louisiana, July 2026.

Insurers have agreed to pay about $933 for this service. The price depends on where it is billed: about $912 from a physician practice, and about $3,020 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$912$741 to $1,122
FacilityA hospital or hospital-owned outpatient department$3,020$1,202 to $4,365

How much rates vary

Facilitymedian $3,020 · 10th to 90th $912 to $7,244Professionalmedian $912 · 10th to 90th $631 to $1,380
$50.0$200.0$1.0K$5.0Kfacility $3,020professional $912

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
$912.01
Median
$2,511.89
Typical High
$5,370.32
Aetna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$891.25
Typical High
$1,318.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$6,918.31
Typical High
$11,481.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,096.48
Typical High
$1,380.38
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$575.44
Typical High
$2,818.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$1,000.00
Typical High
$4,265.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$977.24
Typical High
$1,737.80
United
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$2,951.21
Typical High
$8,912.51
United
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$812.83
Typical High
$1,380.38

Where Louisiana 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.

Louisiana $933 · 21st 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.