Removal of Part of the Roof of the Mouth

Nationwide rates for HCPCS 42120

Removes a section of the palate, the roof of the mouth, or takes out a large growth located there along with surrounding tissue. It is done for tumors and for other damaged or diseased tissue that cannot be treated by lesser means. The resulting gap may be reconstructed, or fitted with a plate that seals the mouth from the nasal cavity.

Rates data updated July 2026.

How much does Removal of Part of the Roof of the Mouth cost?

$6,478

Typical total for the visit. Nationwide, July 2026.

Insurers have agreed to pay about $6,478 for this procedure. That total is two separate charges: $1,349 to the doctor who performs it, and $5,129 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

21% physician fee79% facility fee

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 57 insurance carriers under federal price transparency rules.

What's inside this number

Part of the bill	Who charges it	Typical	Range
Physician feeThe doctor who performs it	The doctor who performs it	$1,349	$1,000 to $2,089
Facility feeThe hospital or surgery center	The hospital or surgery center	$5,129	$1,950 to $9,333

How much rates vary

Facilitymedian $5,129 · 10th to 90th $1,072 to $14,125Professionalmedian $1,349 · 10th to 90th $851 to $3,467

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier Global Typical Low $1,148.15 Median $4,677.35 Typical High $12,022.64	Facility	Global	$1,148.15	$4,677.35	$12,022.64
BCBS Setting Facility Modifier Global Typical Low $3,162.28 Median $8,709.64 Typical High $17,782.79	Facility	Global	$3,162.28	$8,709.64	$17,782.79
Cigna Setting Facility Modifier Global Typical Low $758.58 Median $2,630.27 Typical High $5,888.44	Facility	Global	$758.58	$2,630.27	$5,888.44
United Setting Facility Modifier Global Typical Low $1,122.02 Median $4,265.80 Typical High $11,220.18	Facility	Global	$1,122.02	$4,265.80	$11,220.18

What it costs in each state

The same service costs 4.7 times more in Wisconsin than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Touch or drag across the chart to see any state's rate.

WI $11,258MD $2,390

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.