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Repair Of A Cleft Lip Affecting Both Sides, Single Surgery

Oregon 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 $2,344 · 10th–90th $1,479$19,0550%20%10th90th$2,344Professionalmedian $2,042 · 10th–90th $1,047$3,6310%10%20%10th90th$2,042$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

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
$2,951.21
Median
$13,489.63
Typical High
$23,988.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,819.70
Typical High
$4,466.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$2,137.96
Typical High
$3,311.31
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1,698.24
Median
$2,187.76
Typical High
$2,511.89
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,905.46
Typical High
$2,884.03
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$1,737.80
Median
$2,089.30
Typical High
$3,090.30
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$2,344.23
Typical High
$2,398.83
Providence
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,905.46
Typical High
$2,951.21
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$2,137.96
Typical High
$3,235.94
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$14,125.38
Median
$19,054.61
Typical High
$23,442.29
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,862.09
Median
$2,630.27
Typical High
$3,715.35
United
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$17,378.01
Typical High
$22,908.68
United
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$2,137.96
Typical High
$3,388.44