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Repair of a Small Palate Laceration

Rhode Island 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?

$251

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $251 for this service. The price depends on where it is billed: about $251 from a physician practice, and about $1,230 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 4 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$251$224 to $295
FacilityA hospital or hospital-owned outpatient department$1,230$537 to $1,660

How much rates vary

Facilitymedian $1,230 · 10th to 90th $316 to $3,802Professionalmedian $251 · 10th to 90th $186 to $363
$100$200$500$1K$2K$5Kfacility $1,230professional $251

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
$1,513.56
Median
$1,548.82
Typical High
$3,981.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$245.47
Typical High
$302.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$288.40
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$512.86
Typical High
$512.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$323.59
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$1,202.26
Typical High
$3,801.89
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$257.04
Typical High
$426.58

Where Rhode Island 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.

Rhode Island· 39th of 51

$251

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.