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Repair of a Small Palate Laceration

Georgia 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?

$288

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $2,399 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 7 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$269$214 to $363
FacilityA hospital or hospital-owned outpatient department$2,399$832 to $3,631

How much rates vary

Facilitymedian $2,399 · 10th to 90th $380 to $5,888Professionalmedian $269 · 10th to 90th $186 to $490
$200$500$1K$2K$5K$10Kfacility $2,399professional $269

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
$302.00
Median
$3,548.13
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$251.19
Typical High
$426.58
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$1,819.70
Typical High
$3,981.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$346.74
Typical High
$524.81
CareSource
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$169.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$380.19
Typical High
$549.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$295.12
Typical High
$524.81
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$302.00
Typical High
$524.81
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$870.96
Typical High
$2,238.72
United
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$269.15
Typical High
$489.78

Where Georgia 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.

Georgia· 18th of 51

$288

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.