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Nasolabial Fistula Repair

Utah 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 $6,026 · 10th–90th $891$9,1200%10%10th90th$6,026Professionalmedian $977 · 10th–90th $661$2,3440%10%10th90th$977$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
$891.25
Median
$6,025.60
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$912.01
Typical High
$2,511.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$954.99
Typical High
$1,621.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,905.46
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$8,511.38
Median
$11,481.54
Typical High
$17,782.79
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,202.26
Typical High
$1,621.81
Select Health
Setting
Facility
Modifier
Global
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$1,698.24
Select Health
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,174.90
Typical High
$1,698.24
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,122.02
Typical High
$1,698.24
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$4,466.84
Typical High
$7,079.46
United
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$851.14
Typical High
$1,412.54