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Salivary Fistula Closure

West Virginia rates for HCPCS 42600

Surgically closes a salivary fistula, an abnormal opening that allows saliva to leak from a salivary gland or its duct through the skin or into the mouth. Closing the fistula stops the leakage and its associated irritation.

Rates data updated July 2026.

How much does Salivary Fistula Closure cost?

$447

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $447 for this service. The price depends on where it is billed: about $447 from a physician practice, and about $525 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$447$355 to $525
FacilityA hospital or hospital-owned outpatient department$525$347 to $562

How much rates vary

Facilitymedian $525 · 10th to 90th $347 to $1,413Professionalmedian $447 · 10th to 90th $324 to $661
$500$1K$2K$5K$10Kfacility $525professional $447

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$524.81
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$426.58
Typical High
$660.69
CareSource
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$457.09
CareSource
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$562.34
Typical High
$2,951.21
United
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$1,621.81
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$446.68
Typical High
$741.31

Where West Virginia sits

The same service costs 2.2 times more in Minnesota than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

West Virginia· 50th of 51

$447

MN $1,000MD $447

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.