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Repair of a Small Palate Laceration

Indiana 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 negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $251 for this service. The price depends on where it is billed: about $240 from a physician practice, and about $3,802 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 5 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$240$191 to $275
FacilityA hospital or hospital-owned outpatient department$3,802$2,570 to $5,495

How much rates vary

Facilitymedian $3,802 · 10th to 90th $468 to $8,128Professionalmedian $240 · 10th to 90th $174 to $355
$200$500$1K$2K$5K$10Kfacility $3,802professional $240

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
$204.17
Median
$1,380.38
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$239.88
Typical High
$346.74
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$3,890.45
Typical High
$8,317.64
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$234.42
Typical High
$354.81
CareSource
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$190.55
Typical High
$213.80
CareSource
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$281.84
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$2,041.74
Typical High
$5,754.40
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$234.42
Typical High
$371.54

Where Indiana 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.

Indiana· 40th 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.