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Repair of a Small Palate Laceration

New Jersey 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?

$257

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $257 for this service. The price depends on where it is billed: about $245 from a physician practice, and about $5,129 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$245$191 to $324
FacilityA hospital or hospital-owned outpatient department$5,129$3,311 to $7,079

How much rates vary

Facilitymedian $5,129 · 10th to 90th $447 to $10,471Professionalmedian $245 · 10th to 90th $170 to $525
$200$500$1K$2K$5K$10Kfacility $5,129professional $245

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
$331.13
Median
$5,888.44
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$229.09
Typical High
$426.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$281.84
Typical High
$588.84
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$363.08
Typical High
$524.81
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,621.81
Typical High
$2,570.40
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$269.15
Typical High
$537.03
United
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$2,691.53
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$239.88
Typical High
$489.78

Where New Jersey 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.

New Jersey· 34th of 51

$257

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.