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Repair Of A Tear In The Roof Of The Mouth

Connecticut rates for HCPCS 42182

This procedure surgically closes a tear or wound in the roof of the mouth, called the palate. The surgeon cleans the area and stitches the tissue layers back together to restore a normal palate. It is typically needed after an injury, such as a fall or puncture wound, rather than a birth defect.

Rates data updated October 2026.

How much does Repair Of A Tear In The Roof Of The Mouth cost?

$5,849

Typical total for the visit. In Connecticut, October 2026.

Insurers have agreed to pay about $5,849 for this procedure. That total is two separate charges: $479 to the doctor who performs it, and $5,370 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$479$398 to $661
Facility feeThe hospital or surgery center$5,370$2,630 to $7,586

How much rates vary

Facilitymedian $5,370 · 10th to 90th $776 to $14,125Professionalmedian $479 · 10th to 90th $282 to $813
$200$500$1K$2K$5K$10Kfacility $5,370professional $479

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$3,467.37
Median
$5,248.07
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
None
Typical Low
$275.42
Median
$380.19
Typical High
$478.63
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$4,786.30
Median
$8,317.64
Typical High
$16,218.10
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$323.59
Median
$588.84
Typical High
$812.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$741.31
Median
$6,165.95
Typical High
$7,762.47
Cigna
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$457.09
Typical High
$630.96
ConnectiCare
Setting
Facility
Modifier
None
Typical Low
$446.68
Median
$602.56
Typical High
$758.58
ConnectiCare
Setting
Professional
Modifier
None
Typical Low
$407.38
Median
$524.81
Typical High
$562.34
United
Setting
Facility
Modifier
None
Typical Low
$776.25
Median
$4,786.30
Typical High
$8,709.64
United
Setting
Professional
Modifier
None
Typical Low
$245.47
Median
$446.68
Typical High
$954.99
6 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$144.54
Median
$190.55
Typical High
$239.88
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$57.54
Median
$75.86
Typical High
$95.50
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$213.80
Median
$281.84
Typical High
$354.81
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$42.66
Median
$57.54
Typical High
$70.79
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$28.84
Median
$38.02
Typical High
$47.86
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$199.53
Median
$263.03
Typical High
$331.13

Where Connecticut sits

The same service costs 8.7 times more in Alaska than in North Dakota. 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.

Physician feeFacility fee

Connecticut· 5th of 51

$5,849

$479 physician + $5,370 facility

AK $7,504ND $861

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.