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Nasolabial Fistula Repair

Vermont 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.

Professionalmedian $871 · 10th–90th $724$1,0720%20%40%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
Professional
Modifier
Global
Typical Low
$724.44
Median
$870.96
Typical High
$954.99
Cigna
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$1,000.00
Typical High
$1,479.11
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,148.15
Typical High
$2,137.96
United
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,071.52
Typical High
$1,819.70