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Repair of a Small Palate Laceration

Montana 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?

$309

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $309 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $339 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$269$224 to $398
FacilityA hospital or hospital-owned outpatient department$339$309 to $437

How much rates vary

Facilitymedian $339 · 10th to 90th $245 to $490Professionalmedian $269 · 10th to 90th $174 to $550
$200$500$1Kfacility $339professional $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
Professional
Modifier
Global
Typical Low
$169.82
Median
$234.42
Typical High
$1,047.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$302.00
Typical High
$776.25
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$407.38
Typical High
$478.63
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$407.38
Typical High
$478.63
Providence
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$309.03
Typical High
$562.34
Providence
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$380.19
Typical High
$645.65
United
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$346.74
Typical High
$478.63

Where Montana 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.

Montana· 12th of 51

$309

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.