go back

Cleft Lip Repair, One Side, First Operation

South Dakota 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?

$1,995

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $1,995 for this service. The price depends on where it is billed: about $1,738 from a physician practice, and about $6,310 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 7 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$1,738$1,000 to $2,884
FacilityA hospital or hospital-owned outpatient department$6,310$4,365 to $6,310

How much rates vary

Facilitymedian $6,310 · 10th to 90th $1,413 to $6,310Professionalmedian $1,738 · 10th to 90th $871 to $3,631
$1K$2K$5Kfacility $6,310professional $1,738

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
$6,309.57
Median
$6,309.57
Typical High
$6,309.57
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,000.00
Typical High
$3,630.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,041.74
Median
$2,344.23
Typical High
$2,884.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,445.44
Typical High
$2,818.38
Medica
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,905.46
Typical High
$10,000.00
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,905.46
Median
$2,290.87
Typical High
$2,290.87
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,905.46
Median
$1,905.46
Typical High
$1,905.46
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,698.24
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$4,466.84
Median
$4,466.84
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,778.28
Typical High
$2,818.38
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,905.46
Median
$1,995.26
Typical High
$2,344.23

Where South Dakota 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 Dakota· 16th of 51

$1,995

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.