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Repair of a Small Palate Laceration

Delaware 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?

$245

Typical negotiated rate. In Delaware, July 2026.

Insurers have agreed to pay about $245 for this service. The price depends on where it is billed: about $245 from a physician practice, and about $5,248 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 3 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$245$195 to $288
FacilityA hospital or hospital-owned outpatient department$5,248$3,236 to $5,248

How much rates vary

Facilitymedian $5,248 · 10th to 90th $324 to $5,248Professionalmedian $245 · 10th to 90th $186 to $398
$100$200$500$1K$2K$5Kfacility $5,248professional $245

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
$3,235.94
Median
$5,248.07
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$245.47
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$1,412.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$263.03
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$144.54
Typical High
$501.19
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$229.09
Typical High
$354.81

Where Delaware 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.

Delaware· 44th of 51

$245

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.