go back

Cleft Palate Repair Surgery

Illinois 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 $1,202$10,9650%5%10th90th$5,012Professionalmedian $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
$1,148.15
Median
$4,265.80
Typical High
$10,000.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,071.52
Typical High
$2,398.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,786.30
Median
$8,511.38
Typical High
$15,848.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$1,096.48
Typical High
$1,621.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$831.76
Typical High
$5,623.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,202.26
Typical High
$2,041.74
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,659.59
Typical High
$6,309.57
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,174.90
Typical High
$1,288.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,174.90
United
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$5,370.32
Typical High
$12,302.69
United
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,148.15
Typical High
$1,949.84