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Cleft Lip Repair, One Side, First Operation

New Jersey 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?

$1,738

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $1,738 for this service. The price depends on where it is billed: about $1,047 from a physician practice, and about $9,550 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 5 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$1,047$933 to $1,738
FacilityA hospital or hospital-owned outpatient department$9,550$6,026 to $11,749

How much rates vary

Facilitymedian $9,550 · 10th to 90th $4,467 to $14,454Professionalmedian $1,047 · 10th to 90th $832 to $6,761
$1K$2K$5K$10K$20Kfacility $9,550professional $1,047

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
$4,466.84
Median
$9,549.93
Typical High
$14,125.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,047.13
Typical High
$11,748.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,202.26
Typical High
$2,454.71
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,258.93
Typical High
$1,445.44
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$12,882.50
Median
$19,054.61
Typical High
$30,199.52
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,122.02
Typical High
$2,187.76
United
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$8,709.64
Typical High
$19,498.45
United
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$1,000.00
Typical High
$2,187.76

Where New Jersey 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.

New Jersey· 24th of 51

$1,738

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.