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Nasolabial Fistula Repair

Maryland 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 $1,380 · 10th–90th $724$3,1620%10%20%10th90th$1,380Professionalmedian $794 · 10th–90th $631$1,3490%10%10th90th$794$500.0$1.0K$2.0K$5.0K$10.0K

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
$2,884.03
Median
$2,884.03
Typical High
$2,884.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$794.33
Typical High
$1,230.27
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$660.69
Typical High
$1,000.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$3,090.30
Typical High
$3,890.45
Cigna
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$891.25
Typical High
$1,513.56
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$954.99
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$1,096.48
Typical High
$2,630.27
United
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$870.96
Typical High
$1,548.82
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$1,047.13
Typical High
$1,288.25