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Nasolabial Fistula Repair

Oregon 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 $759$2,0890%20%10th90th$1,380Professionalmedian $1,380 · 10th–90th $724$2,1880%10%20%10th90th$1,380$10.0$100.0$1.0K$10.0K$100.0K$1.0M

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
$1,698.24
Median
$2,238.72
Typical High
$18,620.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$912.01
Typical High
$2,511.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$5,011.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,412.54
Typical High
$2,089.30
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,479.11
Typical High
$2,041.74
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,047.13
Typical High
$1,778.28
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,412.54
Typical High
$2,041.74
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,584.89
Typical High
$1,698.24
Providence
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$1,047.13
Typical High
$1,778.28
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$1,548.82
Typical High
$2,187.76
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$13,489.63
Median
$19,054.61
Typical High
$23,442.29
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$1,698.24
Typical High
$2,290.87
United
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$9,549.93
Typical High
$17,782.79
United
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,445.44
Typical High
$2,187.76