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Cleft Palate Repair Surgery

Alabama rates for HCPCS 42200

This surgery repairs a cleft palate, a birth condition in which the roof of the mouth did not fully join together during development, leaving a gap between the mouth and nasal cavity. The surgeon closes the opening in the soft palate, hard palate, or both, restoring a continuous roof of the mouth to support normal speech, feeding, and swallowing. It's typically performed on infants or young children born with this condition.

Facilitymedian $2,399 · 10th–90th $1,259$5,7540%10%10th90th$2,399Professionalmedian $1,000 · 10th–90th $813$1,8200%20%10th90th$1,000$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,659.59
Typical High
$2,238.72
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,000.00
Typical High
$1,819.70
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$4,265.80
Typical High
$5,754.40
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,513.56
Typical High
$2,137.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,122.02
Typical High
$2,041.74
United
Setting
Facility
Modifier
Global
Typical Low
$1,479.11
Median
$4,365.16
Typical High
$6,918.31
United
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$977.24
Typical High
$1,584.89