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Nasolabial Fistula Repair

Washington 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 $1,698 · 10th–90th $912$15,8490%10%10th90th$1,698Professionalmedian $1,023 · 10th–90th $661$2,1380%10%20%10th90th$1,023$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
$1,202.26
Median
$2,238.72
Typical High
$17,782.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$912.01
Typical High
$2,137.96
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$10,715.19
Median
$18,197.01
Typical High
$32,359.37
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,380.38
Typical High
$1,995.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$1,071.52
Typical High
$8,317.64
Cigna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,174.90
Typical High
$2,238.72
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$1,479.11
Typical High
$5,248.07
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,318.26
Typical High
$2,344.23
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$436.52
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$1,584.89
Typical High
$1,698.24
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,202.26
Typical High
$4,168.69
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,318.26
Typical High
$2,187.76
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$10,964.78
Median
$17,378.01
Typical High
$31,622.78
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,412.54
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$16,982.44
Typical High
$33,113.11
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,096.48
Typical High
$1,995.26
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$870.96
Typical High
$1,230.27