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Repair Of A Tear In The Roof Of The Mouth

New York 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?

$5,141

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

Insurers have agreed to pay about $5,141 for this procedure. That total is two separate charges: $355 to the doctor who performs it, and $4,786 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 9 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$355$275 to $501
Facility feeThe hospital or surgery center$4,786$1,905 to $7,943

How much rates vary

Facilitymedian $4,786 · 10th to 90th $372 to $12,023Professionalmedian $355 · 10th to 90th $245 to $871
$100.0$1.0K$10.0Kfacility $4,786professional $355

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
$331.13
Median
$3,019.95
Typical High
$9,332.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$331.13
Typical High
$562.34
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$7,762.47
Typical High
$13,489.63
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$275.42
Typical High
$645.65
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$1,698.24
Typical High
$6,165.95
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$467.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$5,011.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$436.52
Typical High
$977.24
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$309.03
Typical High
$870.96
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$501.19
Typical High
$741.31
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$416.87
Typical High
$691.83
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$23,442.29
Typical High
$53,703.18
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$436.52
Typical High
$870.96
United
Setting
Facility
Modifier
Global
Typical Low
$1,698.24
Median
$3,981.07
Typical High
$10,471.29
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$501.19
Typical High
$1,513.56
Univera
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$309.03
Typical High
$1,122.02
Univera
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$398.11
Typical High
$812.83

Where New York 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 feeNew York $5,141 · 9th 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.