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Repair of a Small Palate Laceration

Idaho 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 Idaho, July 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $288 from a physician practice, and about $363 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 8 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$288$229 to $398
FacilityA hospital or hospital-owned outpatient department$363$263 to $631

How much rates vary

Facilitymedian $363 · 10th to 90th $219 to $1,413Professionalmedian $288 · 10th to 90th $191 to $513
$200$500$1K$2K$5Kfacility $363professional $288

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
$1,412.54
Median
$4,466.84
Typical High
$7,079.46
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$257.04
Typical High
$549.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$812.83
Typical High
$1,584.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$380.19
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$309.03
Typical High
$457.09
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$316.23
Typical High
$602.56
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$371.54
Typical High
$512.86
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$234.42
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,230.27
Typical High
$1,819.70
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$398.11
Typical High
$512.86
Select Health
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$676.08
Typical High
$1,122.02
Select Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$234.42
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$8,317.64
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$302.00
Typical High
$467.74

Where Idaho 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.

Idaho· 16th 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.