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Repair Of A Cleft Lip Affecting Both Sides, Single Surgery

Ohio 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 $8,128 · 10th–90th $2,239$12,8820%10%20%10th90th$8,128Professionalmedian $1,318 · 10th–90th $1,047$9,1200%20%10th90th$1,318$10.0$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
$2,290.87
Median
$8,912.51
Typical High
$12,589.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,288.25
Typical High
$11,748.98
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$4,365.16
Typical High
$16,982.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,348.96
Typical High
$2,238.72
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$1,148.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$1,862.09
Typical High
$21,379.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,513.56
Typical High
$2,398.83
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$21,379.62
Median
$21,379.62
Typical High
$21,379.62
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,513.56
Typical High
$2,398.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,258.93
Typical High
$2,511.89
United
Setting
Facility
Modifier
Global
Typical Low
$3,311.31
Median
$6,309.57
Typical High
$11,748.98
United
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,258.93
Typical High
$2,137.96