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Cleft Palate Repair Surgery

Indiana 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 $14,791 · 10th–90th $1,096$25,7040%10%10th90th$14,791Professionalmedian $1,000 · 10th–90th $832$1,8620%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
$1,071.52
Median
$4,265.80
Typical High
$22,908.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,000.00
Typical High
$1,905.46
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,570.88
Median
$17,378.01
Typical High
$26,302.68
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,000.00
Typical High
$1,621.81
CareSource
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$933.25
Typical High
$1,047.13
CareSource
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$794.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,548.82
Typical High
$3,890.45
Cigna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,202.26
Typical High
$1,819.70
United
Setting
Facility
Modifier
Global
Typical Low
$4,265.80
Median
$9,549.93
Typical High
$18,197.01
United
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$977.24
Typical High
$1,621.81