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Repair of a Small Palate Laceration

Massachusetts 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 Massachusetts, July 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $282 from a physician practice, and about $1,000 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$282$209 to $427
FacilityA hospital or hospital-owned outpatient department$1,000$251 to $2,344

How much rates vary

Facilitymedian $1,000 · 10th to 90th $224 to $3,631Professionalmedian $282 · 10th to 90th $182 to $631
$200$500$1K$2K$5K$10Kfacility $1,000professional $282

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
$251.19
Median
$2,238.72
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$239.88
Typical High
$524.81
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$1,023.29
Typical High
$19,498.45
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$323.59
Typical High
$1,819.70
BCBS
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$512.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$363.08
Typical High
$363.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$478.63
Typical High
$602.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$323.59
Typical High
$630.96
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$251.19
Typical High
$3,311.31
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$346.74
Typical High
$524.81
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$1,819.70
Typical High
$3,467.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$338.84
Typical High
$645.65
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$1,023.29
Typical High
$19,498.45
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$323.59
Typical High
$1,819.70
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$1,230.27
Typical High
$2,754.23
United
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$354.81
Typical High
$676.08

Where Massachusetts 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.

Massachusetts· 17th 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.