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Cleft Palate Repair Surgery

Maine 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 $4,074 · 10th–90th $4,074$4,0740%50%$4,074Professionalmedian $1,122 · 10th–90th $871$2,2390%10%20%10th90th$1,122$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
$4,073.80
Median
$4,073.80
Typical High
$4,073.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,071.52
Typical High
$2,089.30
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,412.54
Typical High
$2,187.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$977.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,202.26
Typical High
$2,137.96
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,380.38
Typical High
$2,398.83
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,096.48
Typical High
$2,187.76
United
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$12,022.64
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,288.25
Typical High
$2,454.71