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Repair Of A Cleft Lip Affecting Both Sides, Single Surgery

South Carolina 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 $12,023 · 10th–90th $1,413$21,8780%5%10%10th90th$12,023Professionalmedian $1,413 · 10th–90th $1,047$1,9050%20%40%10th90th$1,413$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
$1,412.54
Median
$12,882.50
Typical High
$22,908.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,412.54
Typical High
$1,584.89
BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$11,481.54
Typical High
$18,197.01
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,778.28
Typical High
$2,884.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4,897.79
Median
$4,897.79
Typical High
$4,897.79
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,445.44
Typical High
$2,041.74
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1,819.70
Median
$1,819.70
Typical High
$1,819.70
Medcost
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$1,445.44
Typical High
$2,398.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$16,595.87
Typical High
$25,703.96
United
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,148.15
Typical High
$1,995.26