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Repair Of A Tear In The Roof Of The Mouth

Indiana 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?

$11,288

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

Insurers have agreed to pay about $11,288 for this procedure. That total is two separate charges: $324 to the doctor who performs it, and $10,965 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$324$263 to $372
Facility feeThe hospital or surgery center$10,965$2,818 to $19,953

How much rates vary

Facilitymedian $10,965 · 10th to 90th $407 to $24,547Professionalmedian $324 · 10th to 90th $245 to $479
$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0Kfacility $10,965professional $324

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
$323.59
Median
$575.44
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$323.59
Typical High
$446.68
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$15,488.17
Typical High
$25,703.96
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$338.84
Typical High
$512.86
CareSource
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$257.04
Typical High
$295.12
CareSource
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$407.38
Typical High
$660.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$371.54
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$5,370.32
Typical High
$10,715.19
United
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$323.59
Typical High
$501.19

Where Indiana sits

The same service costs 18.0 times more in Indiana than in West Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility feeIndiana $11,288 · 1st of 50
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.