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Repair Of A Tear In The Roof Of The Mouth

Nebraska 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?

$3,935

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

Insurers have agreed to pay about $3,935 for this procedure. That total is two separate charges: $468 to the doctor who performs it, and $3,467 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$468$347 to $661
Facility feeThe hospital or surgery center$3,467$1,622 to $7,079

How much rates vary

Facilitymedian $3,467 · 10th to 90th $955 to $10,471Professionalmedian $468 · 10th to 90th $245 to $891
$200$500$1K$2K$5K$10K$20Kfacility $3,467professional $468

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
$302.00
Median
$4,466.84
Typical High
$11,481.54
Aetna
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$302.00
Typical High
$436.52
BCBS Nebraska
Setting
Facility
Modifier
None
Typical Low
$7,244.36
Median
$9,772.37
Typical High
$19,952.62
BCBS Nebraska
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$380.19
Typical High
$524.81
Cigna
Setting
Facility
Modifier
None
Typical Low
$954.99
Median
$3,388.44
Typical High
$5,248.07
Cigna
Setting
Professional
Modifier
None
Typical Low
$501.19
Median
$660.69
Typical High
$794.33
Medica
Setting
Facility
Modifier
None
Typical Low
$588.84
Median
$1,819.70
Typical High
$9,772.37
Medica
Setting
Professional
Modifier
None
Typical Low
$457.09
Median
$851.14
Typical High
$2,454.71
Midlands
Setting
Professional
Modifier
None
Typical Low
$588.84
Median
$741.31
Typical High
$812.83
Midlands
Setting
Facility
Modifier
None
Typical Low
$954.99
Median
$4,073.80
Typical High
$5,623.41
Midlands
Setting
Professional
Modifier
None
Typical Low
$501.19
Median
$724.44
Typical High
$912.01
United
Setting
Facility
Modifier
None
Typical Low
$1,174.90
Median
$1,862.09
Typical High
$7,413.10
United
Setting
Professional
Modifier
None
Typical Low
$363.08
Median
$602.56
Typical High
$812.83
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
$120.23
Median
$151.36
Typical High
$165.96
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$47.86
Median
$60.26
Typical High
$66.07
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$177.83
Median
$223.87
Typical High
$245.47
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$35.48
Median
$44.67
Typical High
$48.98
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$23.99
Median
$30.20
Typical High
$33.11
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$165.96
Median
$208.93
Typical High
$229.09

Where Nebraska 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

Nebraska· 14th of 51

$3,935

$468 physician + $3,467 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.