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Cleft Lip Repair, One Side, First Operation

Virginia 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?

$1,413

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $1,413 for this service. The price depends on where it is billed: about $1,202 from a physician practice, and about $5,248 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 8 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$1,202$1,047 to $1,660
FacilityA hospital or hospital-owned outpatient department$5,248$1,445 to $9,333

How much rates vary

Facilitymedian $5,248 · 10th to 90th $1,148 to $15,488Professionalmedian $1,202 · 10th to 90th $977 to $6,166
$1K$2K$5K$10K$20Kfacility $5,248professional $1,202

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
$1,412.54
Median
$5,888.44
Typical High
$15,488.17
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,202.26
Typical High
$6,760.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,606.93
Median
$7,413.10
Typical High
$9,332.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,288.25
Typical High
$1,819.70
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,122.02
Typical High
$8,317.64
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,174.90
Typical High
$1,995.26
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,071.52
Typical High
$1,258.93
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,412.54
Medcost
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$1,230.27
Typical High
$1,995.26
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26
Sentara
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$1,318.26
Typical High
$10,000.00
Sentara
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,318.26
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$6,456.54
Median
$10,964.78
Typical High
$22,387.21
United
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,096.48
Typical High
$1,862.09

Where Virginia 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.

Virginia· 37th of 51

$1,413

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.