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Nasolabial Fistula Repair

Nevada 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?

$851

Typical negotiated rate. In Nevada, July 2026.

Insurers have agreed to pay about $851 for this service. The price depends on where it is billed: about $832 from a physician practice, and about $3,162 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$832$708 to $955
FacilityA hospital or hospital-owned outpatient department$3,162$912 to $4,677

How much rates vary

Facilitymedian $3,162 · 10th to 90th $708 to $8,128Professionalmedian $832 · 10th to 90th $617 to $1,259
$10.0$100.0$1.0K$10.0Kfacility $3,162professional $832

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
$707.95
Median
$3,162.28
Typical High
$5,011.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$794.33
Typical High
$1,122.02
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$8,128.31
Typical High
$8,128.31
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$954.99
Typical High
$1,513.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$3,090.30
Typical High
$3,090.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$870.96
Typical High
$1,380.38
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$794.33
Typical High
$1,202.26
Hometown Health
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$3,162.28
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,258.93
Select Health
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$758.58
Typical High
$851.14
Select Health
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$537.03
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$2,630.27
Typical High
$4,265.80
United
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$851.14
Typical High
$1,412.54

Where Nevada 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.

Nevada $851 · 45th 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.