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Nasolabial Fistula Repair

Rhode Island 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 $3,802 · 10th–90th $871$7,5860%10%20%10th90th$3,802Professionalmedian $871 · 10th–90th $708$1,2020%20%10th90th$871$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
$3,019.95
Median
$3,715.35
Typical High
$3,981.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$851.14
Typical High
$1,047.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$977.24
Typical High
$1,659.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$5,370.32
Typical High
$5,370.32
Cigna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,122.02
Typical High
$1,862.09
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$3,890.45
Typical High
$8,912.51
United
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$891.25
Typical High
$1,479.11