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Repair of a Small Palate Laceration

Washington, DC rates for HCPCS 42180

This surgery repairs a cut or tear in the palate, the roof of the mouth, that is small in size. The surgeon cleans the wound and closes it with stitches to restore a normal, intact palate. It is typically used after an accidental injury, such as a fall with an object in the mouth, rather than for a birth-related palate condition.

Rates data updated July 2026.

How much does Repair of a Small Palate Laceration cost?

$251

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $251 for this service. Most negotiated rates run $204 to $295.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2,138 · 10th to 90th $224 to $7,762Professionalmedian $224 · 10th to 90th $186 to $309
$200$500$1K$2K$5Kfacility $2,138professional $224

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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$2,754.23
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$223.87
Typical High
$309.03
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$199.53
Typical High
$2,089.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$263.03
Typical High
$691.83
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$288.40
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$549.54
Typical High
$3,162.28
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$251.19
Typical High
$524.81

Where Washington, DC sits

The same service costs 2.2 times more in Minnesota than in West Virginia. 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.

Washington, DC· 38th of 51

$251

MN $501WV $224

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.