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Massachusetts rates for HCPCS 42200

Palatoplasty for cleft palate, soft and/or hard palate only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $3,630.78 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,096.48 / $3,467.37
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $4,897.79 / $16,595.87
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,445.44 / $9,772.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,862.09 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,047.13 / $6,456.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $1,230.27 / $2,511.89
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $1,862.09 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,258.93 / $1,862.09
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $5,011.87 / $13,182.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,584.89 / $2,398.83
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,623.41 / $5,623.41 / $5,623.41
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $4,897.79 / $16,595.87
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,445.44 / $9,772.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $5,370.32 / $13,182.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,348.96 / $2,630.27