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Repair of a Small Palate Laceration

Tennessee 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 Tennessee, 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 $1,380 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$251$195 to $309
FacilityA hospital or hospital-owned outpatient department$1,380$603 to $2,399

How much rates vary

Facilitymedian $1,380 · 10th to 90th $363 to $4,074Professionalmedian $251 · 10th to 90th $178 to $407
$200$500$1K$2K$5K$10Kfacility $1,380professional $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
$467.74
Median
$1,778.28
Typical High
$4,073.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$245.47
Typical High
$371.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$1,445.44
Typical High
$2,041.74
BCBS
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$309.03
Typical High
$524.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$371.54
Typical High
$616.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$269.15
Typical High
$446.68
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$19,498.45
Typical High
$19,498.45
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,819.70
Median
$2,137.96
Typical High
$2,137.96
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$741.31
Typical High
$1,905.46
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$257.04
Typical High
$436.52

Where Tennessee 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.

Tennessee· 41st 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.