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Nasolabial Fistula Repair

South Carolina 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 $1,259 · 10th–90th $776$14,7910%10%10th90th$1,259Professionalmedian $851 · 10th–90th $646$1,3490%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
$794.33
Median
$10,471.29
Typical High
$21,877.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$851.14
Typical High
$1,258.93
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,187.76
Median
$6,309.57
Typical High
$10,715.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$776.25
Typical High
$1,202.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$812.83
Typical High
$3,801.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$954.99
Typical High
$1,862.09
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,122.02
Typical High
$1,318.26
Medcost
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$1,000.00
Typical High
$1,621.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$10,232.93
Typical High
$17,378.01
United
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$831.76
Typical High
$1,479.11