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Repair Of A Tear In The Roof Of The Mouth

Washington, DC 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 July 2026.

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

$324

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $324 for this service. Most negotiated rates run $288 to $380.

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.

How much rates vary

Facilitymedian $4,074 · 10th to 90th $302 to $7,762Professionalmedian $309 · 10th to 90th $251 to $398
$200$500$1K$2K$5K$10K$20Kfacility $4,074professional $309

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
$302.00
Median
$4,073.80
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$302.00
Typical High
$398.11
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$269.15
Typical High
$4,073.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$363.08
Typical High
$891.25
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$371.54
Typical High
$660.69
United
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$10,000.00
Typical High
$30,902.95
United
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$338.84
Typical High
$707.95

Where Washington, DC 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.

Washington, DC· 48th of 51

$324

MN $676WV $302

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.