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Repair Of A Tear In The Roof Of The Mouth

West 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?

$626

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

Insurers have agreed to pay about $626 for this procedure. That total is two separate charges: $302 to the doctor who performs it, and $324 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 4 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$302$257 to $363
Facility feeThe hospital or surgery center$324$257 to $398

How much rates vary

Facilitymedian $324 · 10th to 90th $257 to $1,622Professionalmedian $302 · 10th to 90th $240 to $417
$200.0$500.0$1.0K$2.0K$5.0K$10.0Kfacility $324professional $302

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
$257.04
Median
$323.59
Typical High
$1,412.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$302.00
Typical High
$398.11
CareSource
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$331.13
CareSource
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$380.19
Typical High
$1,621.81
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$2,951.21
Typical High
$16,595.87
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$316.23
Typical High
$512.86

Where West 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 feeWest Virginia $626 · 50th 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.