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Repair Of A Cleft Lip Affecting Both Sides, Single Surgery

Michigan 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 $6,918 · 10th–90th $1,778$10,2330%20%10th90th$6,918Professionalmedian $1,380 · 10th–90th $1,023$1,9950%10%20%10th90th$1,380$500.0$1.0K$2.0K$5.0K$10.0K

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
$1,513.56
Median
$6,918.31
Typical High
$9,549.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,412.54
Typical High
$2,884.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,023.29
BCBS
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$1,023.29
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,230.27
Typical High
$4,897.79
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$4,897.79
Typical High
$6,918.31
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,348.96
Typical High
$1,862.09
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$4,677.35
Median
$4,677.35
Typical High
$4,897.79
United
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$7,943.28
Typical High
$14,791.08
United
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,412.54
Typical High
$1,995.26