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Repair Of A Tear In The Roof Of The Mouth

New Jersey 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?

$6,357

Typical total for the visit. In New Jersey, July 2026.

Insurers have agreed to pay about $6,357 for this procedure. That total is two separate charges: $331 to the doctor who performs it, and $6,026 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$331$263 to $427
Facility feeThe hospital or surgery center$6,026$4,467 to $8,511

How much rates vary

Facilitymedian $6,026 · 10th to 90th $575 to $10,965Professionalmedian $331 · 10th to 90th $234 to $676
$200$500$1K$2K$5K$10K$20Kfacility $6,026professional $331

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
$436.52
Median
$6,025.60
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$309.03
Typical High
$549.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$380.19
Typical High
$724.44
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$467.74
Typical High
$724.44
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$19,054.61
Typical High
$27,542.29
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$363.08
Typical High
$724.44
United
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$5,888.44
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$323.59
Typical High
$645.65

Where New Jersey sits

The same service costs 18.0 times more in Indiana than in West Virginia. 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

New Jersey· 5th of 50

$6,357

$331 physician + $6,026 facility

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.