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Repair Of A Tear In The Roof Of The Mouth

Illinois 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?

$2,077

Typical total for the visit. In Illinois, July 2026.

Insurers have agreed to pay about $2,077 for this procedure. That total is two separate charges: $339 to the doctor who performs it, and $1,738 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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$339$288 to $457
Facility feeThe hospital or surgery center$1,738$724 to $4,169

How much rates vary

Facilitymedian $1,738 · 10th to 90th $339 to $6,026Professionalmedian $339 · 10th to 90th $251 to $603
$200$500$1K$2K$5K$10Kfacility $1,738professional $339

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
$338.84
Median
$1,584.89
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$331.13
Typical High
$575.44
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$7,244.36
Typical High
$10,232.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$380.19
Typical High
$602.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,288.25
Typical High
$5,623.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$389.05
Typical High
$645.65
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$512.86
Typical High
$1,445.44
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$323.59
Typical High
$446.68
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$4,365.16
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$371.54
Typical High
$616.60

Where Illinois sits

The same service costs 18.0 times more in Indiana 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.

Physician feeFacility fee

Illinois· 31st of 50

$2,077

$339 physician + $1,738 facility

IN $11,288WV $626

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.