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Repair Of A Cleft Lip Affecting Both Sides, Single Surgery

California rates for HCPCS 40701

This surgery repairs a cleft lip that affects both sides of the upper lip, correcting the separation and reshaping the lip and nose in one operation. It restores a more typical lip shape and function, and is usually performed on an infant. Repairing both sides together in a single procedure is chosen when the cleft on each side allows it.

Rates data updated July 2026.

Facilitymedian $10,233 · 10th–90th $3,631$18,6210%10%10th90th$10,233Professionalmedian $1,514 · 10th–90th $1,000$6,4570%20%10th90th$1,514$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$4,466.84
Median
$10,000.00
Typical High
$23,988.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,412.54
Typical High
$6,918.31
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,025.60
Median
$10,471.29
Typical High
$17,782.79
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,348.96
Median
$1,862.09
Typical High
$3,801.89
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$9,549.93
Typical High
$19,498.45
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$870.96
Typical High
$2,691.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$1,288.25
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,412.54
Typical High
$2,818.38
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,230.27
Typical High
$1,584.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,318.26
Typical High
$4,677.35
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$33,884.42
Typical High
$33,884.42
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$8,912.51
Median
$10,232.93
Typical High
$10,232.93
Molina
Setting
Professional
Modifier
Global
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$1,698.24
Providence
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,380.38
Typical High
$2,137.96
Providence
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,412.54
Typical High
$3,019.95
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$3,890.45
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,258.93
Typical High
$1,819.70
United
Setting
Facility
Modifier
Global
Typical Low
$6,760.83
Median
$11,748.98
Typical High
$25,118.86
United
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,258.93
Typical High
$2,630.27