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Nasolabial Fistula Repair

Wyoming 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.

How much does Nasolabial Fistula Repair cost?

$912

Typical physician fee. In Wyoming, July 2026.

Insurers have agreed to pay about $912 for this service. Most negotiated rates run $794 to $2,239.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $10,471 · 10th to 90th $2,630 to $12,023Professionalmedian $912 · 10th to 90th $631 to $3,236
$1.0K$2.0K$5.0K$10.0Kfacility $10,471professional $912

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$794.33
Typical High
$1,096.48
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$2,691.53
Typical High
$3,467.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,348.96
Typical High
$2,398.83
United
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$10,471.29
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,288.25
Typical High
$2,570.40

Where Wyoming sits

The same service costs 2.2 times more in Minnesota than in West Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Wyoming $912 · 27th of 51
MN $1,738WV $794

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.