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Texas rates for HCPCS 42260

Repair of nasolabial fistula

Facilitymedian $2,455 · 10th–90th $794$11,4820%10%10th90th$2,455Professionalmedian $851 · 10th–90th $646$1,3180%20%10th90th$851$10.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $3,715.35 / $12,589.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $870.96 / $1,288.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $7,244.36 / $14,454.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $794.33 / $1,148.15
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $588.84 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $3,548.13 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $954.99 / $1,621.81
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $33,884.42 / $33,884.42
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,165.95 / $7,244.36 / $7,244.36
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,000.00 / $2,041.74
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $891.25 / $1,513.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $724.44
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $1,737.80 / $2,238.72
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $954.99 / $1,698.24
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $977.24 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $4,073.80 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $812.83 / $1,258.93
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $812.83 / $933.25