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Repair of a Small Palate Laceration

Michigan 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 Michigan, July 2026.

Insurers have agreed to pay about $245 for this service. The price depends on where it is billed: about $240 from a physician practice, and about $2,042 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 6 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$195 to $275
FacilityA hospital or hospital-owned outpatient department$2,042$676 to $4,898

How much rates vary

Facilitymedian $2,042 · 10th to 90th $240 to $4,898Professionalmedian $240 · 10th to 90th $174 to $324
$100$200$500$1K$2K$5Kfacility $2,042professional $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
$239.88
Median
$2,041.74
Typical High
$4,897.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$239.88
Typical High
$323.59
BCBS
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
BCBS
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$162.18
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$257.04
Typical High
$501.19
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$724.44
Typical High
$4,897.79
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$251.19
Typical High
$354.81
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$794.33
Typical High
$1,122.02
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$933.25
Typical High
$1,737.80
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$398.11

Where Michigan 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.

Michigan· 42nd 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.