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Repair Of A Tear In The Roof Of The Mouth

Virginia 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?

$786

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

Insurers have agreed to pay about $786 for this procedure. That total is two separate charges: $339 to the doctor who performs it, and $447 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$339$288 to $407
Facility feeThe hospital or surgery center$447$324 to $3,020

How much rates vary

Facilitymedian $447 · 10th to 90th $282 to $7,079Professionalmedian $339 · 10th to 90th $251 to $550
$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0Kfacility $447professional $339

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
$363.08
Median
$3,467.37
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$323.59
Typical High
$446.68
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,606.93
Median
$7,413.10
Typical High
$9,332.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$380.19
Typical High
$588.84
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$269.15
Typical High
$2,691.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$2,691.53
Typical High
$3,311.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$363.08
Typical High
$562.34
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$389.05
Typical High
$645.65
Medcost
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$467.74
Typical High
$616.60
Medcost
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$398.11
Typical High
$616.60
Medcost
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$724.44
Sentara
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$331.13
Typical High
$1,445.44
Sentara
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$398.11
Typical High
$1,548.82
United
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$5,623.41
Typical High
$13,182.57
United
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$346.74
Typical High
$562.34

Where Virginia 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 feeVirginia $786 · 48th 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.