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Repair Of A Tear In The Roof Of The Mouth

Kentucky 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?

$2,497

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

Insurers have agreed to pay about $2,497 for this procedure. That total is two separate charges: $309 to the doctor who performs it, and $2,188 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$309$263 to $355
Facility feeThe hospital or surgery center$2,188$1,259 to $3,548

How much rates vary

Facilitymedian $2,188 · 10th to 90th $398 to $5,129Professionalmedian $309 · 10th to 90th $240 to $437
$50.0$200.0$1.0K$5.0Kfacility $2,188professional $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
$316.23
Median
$562.34
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$309.03
Typical High
$398.11
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$2,398.83
Typical High
$4,365.16
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$302.00
Typical High
$426.58
CareSource
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$275.42
Typical High
$380.19
CareSource
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$295.12
Typical High
$380.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$380.19
Typical High
$1,621.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$3,388.44
Typical High
$6,025.60
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$338.84
Typical High
$549.54

Where Kentucky 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 feeKentucky $2,497 · 29th 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.