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Nasolabial Fistula Repair

New Mexico 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 $1,000 · 10th–90th $708$2,0420%10%10th90th$1,000Professionalmedian $851 · 10th–90th $646$1,3490%10%20%10th90th$851$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
$912.01
Median
$1,318.26
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$851.14
Typical High
$1,230.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,023.29
Typical High
$1,445.44
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,230.27
Providence
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$977.24
Typical High
$1,698.24
Providence
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,071.52
Typical High
$1,778.28
United
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$6,918.31
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,047.13
Typical High
$1,621.81