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Cleft Lip Repair, One Side, First Operation

North Carolina rates for HCPCS 40700

Reconstructive surgery to close a cleft in the lip on one side and reshape the nostril distorted by it. The surgeon brings the separated skin, muscle, and lining together so the lip forms a continuous border and the muscle works as a single unit. It is the first definitive repair rather than a later revision.

Rates data updated July 2026.

How much does Cleft Lip Repair, One Side, First Operation cost?

$1,585

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $1,585 for this service. The price depends on where it is billed: about $1,175 from a physician practice, and about $6,457 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 6 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$1,175$977 to $2,512
FacilityA hospital or hospital-owned outpatient department$6,457$1,660 to $14,125

How much rates vary

Facilitymedian $6,457 · 10th to 90th $1,047 to $14,454Professionalmedian $1,175 · 10th to 90th $912 to $2,884
$1K$2K$5K$10K$20Kfacility $6,457professional $1,175

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
$1,584.89
Median
$6,456.54
Typical High
$14,454.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,047.13
Typical High
$2,884.03
BCBS
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,698.24
Typical High
$2,691.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,288.25
Typical High
$2,187.76
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,479.11
Medcost
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,174.90
Typical High
$1,659.59
United
Setting
Facility
Modifier
Global
Typical Low
$6,025.60
Median
$11,748.98
Typical High
$23,988.33
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,000.00
Typical High
$1,905.46
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$16,982.44
Typical High
$33,884.42
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$8,709.64
Median
$10,000.00
Typical High
$10,000.00

Where North Carolina sits

The same service costs 5.5 times more in Hawaii than in West Virginia. 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.

North Carolina· 33rd of 51

$1,585

HI $5,495WV $1,000

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.