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Cleft Lip Repair, One Side, First Operation

South 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?

$1,202

Typical negotiated rate. In South Carolina, July 2026.

Insurers have agreed to pay about $1,202 for this service. The price depends on where it is billed: about $1,175 from a physician practice, and about $12,023 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 $1,349
FacilityA hospital or hospital-owned outpatient department$12,023$5,623 to $17,783

How much rates vary

Facilitymedian $12,023 · 10th to 90th $1,175 to $21,878Professionalmedian $1,175 · 10th to 90th $912 to $1,995
$50$200$1K$5K$20Kfacility $12,023professional $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
$1,174.90
Median
$12,882.50
Typical High
$22,908.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,174.90
Typical High
$1,995.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$11,481.54
Typical High
$18,197.01
BCBS
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,096.48
Typical High
$1,949.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4,786.30
Median
$4,786.30
Typical High
$4,786.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,202.26
Typical High
$1,698.24
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,412.54
Medcost
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,174.90
Typical High
$1,949.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$16,595.87
Typical High
$25,703.96
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$977.24
Typical High
$1,621.81

Where South 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.

South Carolina· 46th of 51

$1,202

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.