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Cleft Palate Repair Surgery

Idaho 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 $4,365 · 10th–90th $1,096$10,4710%10%10th90th$4,365Professionalmedian $1,288 · 10th–90th $851$2,6920%10%10th90th$1,288$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
$4,365.16
Median
$8,709.64
Typical High
$8,912.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,148.15
Typical High
$2,691.53
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,691.53
Median
$6,025.60
Typical High
$15,135.61
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$1,737.80
Typical High
$1,819.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,348.96
Typical High
$1,778.28
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,380.38
Typical High
$2,754.23
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,513.56
Typical High
$2,290.87
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$9,772.37
Median
$13,182.57
Typical High
$18,620.87
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,778.28
Typical High
$1,949.84
Select Health
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$851.14
Typical High
$10,964.78
United
Setting
Facility
Modifier
Global
Typical Low
$10,232.93
Median
$22,387.21
Typical High
$27,542.29
United
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,230.27
Typical High
$1,862.09