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Repair of a Small Palate Laceration

North Carolina 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?

$324

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $324 for this service. The price depends on where it is billed: about $331 from a physician practice, and about $288 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 7 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$331$245 to $575
FacilityA hospital or hospital-owned outpatient department$288$229 to $407

How much rates vary

Facilitymedian $288 · 10th to 90th $182 to $1,000Professionalmedian $331 · 10th to 90th $195 to $631
$100$200$500$1K$2K$5Kfacility $288professional $331

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
$181.97
Median
$380.19
Typical High
$5,495.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$251.19
Typical High
$537.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$223.87
Typical High
$251.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$389.05
Typical High
$691.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$398.11
Typical High
$524.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$302.00
Typical High
$549.54
Medcost
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
Medcost
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$269.15
Typical High
$426.58
Medcost
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$645.65
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$489.78
Typical High
$1,513.56
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$234.42
Typical High
$416.87
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$19,498.45
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,819.70
Median
$1,819.70
Typical High
$2,137.96

Where North Carolina 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.

North Carolina· 9th of 51

$324

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.