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Repair of a Small Palate Laceration

Vermont 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?

$245

Typical physician fee. In Vermont, July 2026.

Insurers have agreed to pay about $245 for this service. Most negotiated rates run $195 to $263.

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.

How much rates vary

Professionalmedian $245 · 10th to 90th $186 to $309
$200$500professional $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
Professional
Modifier
Global
Typical Low
$186.21
Median
$245.47
Typical High
$288.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$275.42
Typical High
$416.87
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$346.74
Typical High
$645.65
United
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$309.03
Typical High
$537.03

Where Vermont 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.

Vermont· 45th of 51

$245

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.