go back

Repair of a Small Palate Laceration

West Virginia 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?

$224

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $224 for this service. The price depends on where it is billed: about $224 from a physician practice, and about $245 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$224$186 to $263
FacilityA hospital or hospital-owned outpatient department$245$182 to $295

How much rates vary

Facilitymedian $245 · 10th to 90th $182 to $1,230Professionalmedian $224 · 10th to 90th $170 to $316
$200$500$1Kfacility $245professional $224

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
$181.97
Median
$245.47
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$223.87
Typical High
$309.03
CareSource
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$239.88
CareSource
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$281.84
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$457.09
Typical High
$1,513.56
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$229.09
Typical High
$371.54

Where West Virginia 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.

West Virginia· 51st of 51

$224

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.