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Repair of a Small Palate Laceration

South 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?

$251

Typical negotiated rate. In South Carolina, 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 $363 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 6 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$200 to $302
FacilityA hospital or hospital-owned outpatient department$363$269 to $955

How much rates vary

Facilitymedian $363 · 10th to 90th $224 to $6,918Professionalmedian $251 · 10th to 90th $182 to $380
$200$500$1K$2K$5K$10K$20Kfacility $363professional $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
$223.87
Median
$5,623.41
Typical High
$21,877.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$245.47
Typical High
$371.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$794.33
Typical High
$1,445.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$257.04
Typical High
$380.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$371.54
Typical High
$436.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$288.40
Typical High
$549.54
Medcost
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$338.84
Typical High
$354.81
Medcost
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$288.40
Typical High
$478.63
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$1,122.02
Typical High
$3,548.13
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$239.88
Typical High
$416.87

Where South 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.

South Carolina· 37th 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.