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Repair Of A Tear In The Roof Of The Mouth

Michigan 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?

$3,208

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

Insurers have agreed to pay about $3,208 for this procedure. That total is two separate charges: $324 to the doctor who performs it, and $2,884 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$324$275 to $372
Facility feeThe hospital or surgery center$2,884$1,995 to $4,898

How much rates vary

Facilitymedian $2,884 · 10th to 90th $417 to $7,079Professionalmedian $324 · 10th to 90th $245 to $437
$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0Kfacility $2,884professional $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
$416.87
Median
$2,884.03
Typical High
$6,918.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$323.59
Typical High
$416.87
BCBS
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$354.81
Typical High
$354.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$346.74
Typical High
$676.08
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$977.24
Typical High
$4,897.79
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$331.13
Typical High
$467.74
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$1,023.29
Typical High
$1,412.54
United
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$5,248.07
Typical High
$14,791.08
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$363.08
Typical High
$524.81

Where Michigan 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 feeMichigan $3,208 · 23rd 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.