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Repair of a Small Palate Laceration

New York 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?

$295

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $295 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $3,090 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 9 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$214 to $398
FacilityA hospital or hospital-owned outpatient department$3,090$1,514 to $4,677

How much rates vary

Facilitymedian $3,090 · 10th to 90th $269 to $7,586Professionalmedian $269 · 10th to 90th $186 to $676
$200$500$1K$2K$5K$10Kfacility $3,090professional $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
Facility
Modifier
Global
Typical Low
$239.88
Median
$2,951.21
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$245.47
Typical High
$436.52
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$3,630.78
Typical High
$5,011.87
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$223.87
Typical High
$501.19
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$1,258.93
Typical High
$4,073.80
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$363.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$1,318.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$323.59
Typical High
$758.58
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$204.17
Typical High
$512.86
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$380.19
Typical High
$575.44
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$338.84
Typical High
$537.03
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$23,442.29
Typical High
$53,703.18
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$398.11
Typical High
$676.08
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$2,344.23
Typical High
$4,897.79
United
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$389.05
Typical High
$1,000.00
Univera
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$223.87
Typical High
$676.08
Univera
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$316.23
Typical High
$537.03

Where New York 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 York· 14th of 51

$295

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.