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Cleft Palate Repair Surgery

Kentucky 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 $1,479$10,4710%5%10th90th$4,365Professionalmedian $977 · 10th–90th $813$1,7380%20%10th90th$977$50.0$200.0$1.0K$5.0K

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
$891.25
Median
$1,995.26
Typical High
$10,471.29
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,000.00
Typical High
$1,949.84
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,818.38
Median
$4,466.84
Typical High
$11,481.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$891.25
Typical High
$1,174.90
CareSource
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$977.24
Typical High
$1,380.38
CareSource
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,071.52
Typical High
$1,380.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,548.82
Median
$1,548.82
Typical High
$2,511.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,230.27
Typical High
$7,762.47
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$4,677.35
Typical High
$10,471.29
United
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,071.52
Typical High
$1,659.59