go back

Nasolabial Fistula Repair

Minnesota 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?

$1,738

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $1,738 for this service. The price depends on where it is billed: about $1,698 from a physician practice, and about $2,884 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 6 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$1,698$1,122 to $2,455
FacilityA hospital or hospital-owned outpatient department$2,884$1,380 to $6,607

How much rates vary

Facilitymedian $2,884 · 10th to 90th $794 to $14,454Professionalmedian $1,698 · 10th to 90th $794 to $3,090
$100.0$1.0K$10.0Kfacility $2,884professional $1,698

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
$630.96
Median
$831.76
Typical High
$831.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$831.76
Typical High
$1,202.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,890.45
Median
$11,481.54
Typical High
$26,915.35
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,949.84
Typical High
$3,090.30
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$3,090.30
Typical High
$8,511.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$2,089.30
Typical High
$3,630.78
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$3,019.95
Typical High
$6,606.93
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$1,348.96
Median
$2,137.96
Typical High
$3,388.44
Medica
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$1,122.02
Typical High
$2,454.71
Medica
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,698.24
Typical High
$6,456.54
United
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$5,011.87
Typical High
$15,135.61
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,380.38
Typical High
$2,691.53

Where Minnesota 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.

Minnesota $1,738 · 1st 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.