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Cleft Palate Repair Surgery

Connecticut 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 $7,079 · 10th–90th $3,090$14,1250%10%10th90th$7,079Professionalmedian $1,096 · 10th–90th $832$2,5700%10%20%10th90th$1,096$50.0$200.0$1.0K$5.0K$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
$3,090.30
Median
$6,606.93
Typical High
$11,481.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,023.29
Typical High
$2,691.53
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$8,317.64
Median
$14,125.38
Typical High
$16,595.87
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,584.89
Typical High
$2,344.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$5,888.44
Typical High
$8,317.64
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,348.96
Typical High
$2,511.89
ConnectiCare
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,174.90
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,348.96
Typical High
$1,737.80
United
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$9,772.37
Typical High
$16,218.10
United
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,513.56
Typical High
$3,019.95