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Repair Of A Tear In The Roof Of The Mouth

Kansas 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?

$1,412

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

Insurers have agreed to pay about $1,412 for this procedure. That total is two separate charges: $389 to the doctor who performs it, and $1,023 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$389$331 to $537
Facility feeThe hospital or surgery center$1,023$447 to $3,467

How much rates vary

Facilitymedian $1,023 · 10th to 90th $427 to $5,129Professionalmedian $389 · 10th to 90th $282 to $1,950
$500$1K$2K$5K$10Kfacility $1,023professional $389

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
$1,288.25
Median
$3,630.78
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$354.81
Typical High
$537.03
BCBS Kansas
Setting
Facility
Modifier
None
Typical Low
$426.58
Median
$446.68
Typical High
$3,467.37
BCBS Kansas
Setting
Professional
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$457.09
Cigna
Setting
Facility
Modifier
None
Typical Low
$562.34
Median
$3,981.07
Typical High
$4,073.80
Cigna
Setting
Professional
Modifier
None
Typical Low
$263.03
Median
$371.54
Typical High
$549.54
Medica
Setting
Facility
Modifier
None
Typical Low
$457.09
Median
$1,412.54
Typical High
$16,218.10
Medica
Setting
Professional
Modifier
None
Typical Low
$363.08
Median
$1,949.84
Typical High
$2,454.71
United
Setting
Facility
Modifier
None
Typical Low
$831.76
Median
$1,737.80
Typical High
$4,677.35
United
Setting
Professional
Modifier
None
Typical Low
$281.84
Median
$346.74
Typical High
$501.19
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
$134.90
Median
$177.83
Typical High
$269.15
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$54.95
Median
$70.79
Typical High
$109.65
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$204.17
Median
$263.03
Typical High
$407.38
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$40.74
Median
$53.70
Typical High
$81.28
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$26.92
Median
$35.48
Typical High
$53.70
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$190.55
Median
$245.47
Typical High
$380.19

Where Kansas 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

Kansas· 48th of 51

$1,412

$389 physician + $1,023 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.