go back

Cleft Palate Repair Surgery

Iowa 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 $5,012 · 10th–90th $1,318$12,5890%10%20%10th90th$5,012Professionalmedian $1,175 · 10th–90th $851$2,6920%20%10th90th$1,175$10.0$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
$1,548.82
Median
$5,128.61
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,071.52
Typical High
$2,187.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7,244.36
Median
$7,244.36
Typical High
$7,244.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$2,137.96
Typical High
$2,691.53
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,621.81
Typical High
$4,897.79
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,905.46
Typical High
$14,454.40
Medica
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,698.24
Typical High
$9,772.37
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$2,187.76
Typical High
$2,511.89
Midlands
Setting
Facility
Modifier
Global
Typical Low
$7,244.36
Median
$7,244.36
Typical High
$7,244.36
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$1,698.24
Typical High
$2,511.89
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$1,698.24
Typical High
$2,398.83
United
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$9,772.37
Typical High
$15,488.17
United
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,348.96
Typical High
$2,454.71
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,819.70
Typical High
$2,137.96