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Repair Of A Cleft Lip Affecting Both Sides, Single Surgery

Utah 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 $6,026 · 10th–90th $1,479$12,0230%10%10th90th$6,026Professionalmedian $1,349 · 10th–90th $1,148$3,4670%20%10th90th$1,349$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
$1,479.11
Median
$4,570.88
Typical High
$10,232.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,348.96
Typical High
$6,456.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,479.11
Typical High
$1,995.26
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$4,786.30
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$8,511.38
Median
$11,481.54
Typical High
$17,782.79
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$1,737.80
Typical High
$2,290.87
Select Health
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$2,137.96
Typical High
$2,137.96
Select Health
Setting
Professional
Modifier
Global
Typical Low
$1,258.93
Median
$1,905.46
Typical High
$2,238.72
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,621.81
Typical High
$3,162.28
United
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$5,128.61
Typical High
$13,803.84
United
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,230.27
Typical High
$1,905.46