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Repair Of A Tear In The Roof Of The Mouth

Georgia 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?

$2,021

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

Insurers have agreed to pay about $2,021 for this procedure. That total is two separate charges: $437 to the doctor who performs it, and $1,585 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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$437$339 to $562
Facility feeThe hospital or surgery center$1,585$871 to $3,802

How much rates vary

Facilitymedian $1,585 · 10th to 90th $537 to $6,026Professionalmedian $437 · 10th to 90th $257 to $724
$200$500$1K$2K$5K$10Kfacility $1,585professional $437

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
$331.13
Median
$4,466.84
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$331.13
Typical High
$398.11
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$512.86
Median
$1,174.90
Typical High
$7,244.36
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$446.68
Typical High
$691.83
CareSource
Setting
Professional
Modifier
None
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Cigna
Setting
Facility
Modifier
None
Typical Low
$524.81
Median
$3,388.44
Typical High
$4,265.80
Cigna
Setting
Professional
Modifier
None
Typical Low
$281.84
Median
$457.09
Typical High
$691.83
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$407.38
Typical High
$691.83
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
United
Setting
Facility
Modifier
None
Typical Low
$851.14
Median
$1,479.11
Typical High
$5,011.87
United
Setting
Professional
Modifier
None
Typical Low
$263.03
Median
$446.68
Typical High
$891.25
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
$125.89
Median
$165.96
Typical High
$190.55
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$51.29
Median
$66.07
Typical High
$77.62
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$190.55
Median
$245.47
Typical High
$288.40
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$38.02
Median
$50.12
Typical High
$57.54
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$25.70
Median
$33.11
Typical High
$38.02
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$177.83
Median
$229.09
Typical High
$269.15

Where Georgia 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

Georgia· 40th of 51

$2,021

$437 physician + $1,585 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.