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Repair Of A Tear In The Roof Of The Mouth

Ohio 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?

$3,344

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

Insurers have agreed to pay about $3,344 for this procedure. That total is two separate charges: $324 to the doctor who performs it, and $3,020 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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$324$263 to $380
Facility feeThe hospital or surgery center$3,020$1,047 to $5,248

How much rates vary

Facilitymedian $3,020 · 10th to 90th $398 to $12,023Professionalmedian $324 · 10th to 90th $245 to $501
$200$500$1K$2K$5K$10Kfacility $3,020professional $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
$354.81
Median
$3,019.95
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$323.59
Typical High
$478.63
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$3,388.44
Typical High
$16,982.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$309.03
Typical High
$489.78
CareSource
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$275.42
Typical High
$3,630.78
CareSource
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$302.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$489.78
Typical High
$4,897.79
Cigna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$371.54
Typical High
$645.65
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$524.81
Typical High
$4,897.79
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$371.54
Typical High
$616.60
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$190.55
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$9,120.11
Median
$9,120.11
Typical High
$9,120.11
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$346.74
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$4,466.84
Typical High
$8,128.31
United
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$323.59
Typical High
$537.03

Where Ohio 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

Ohio· 22nd of 50

$3,344

$324 physician + $3,020 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.