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Cleft Palate Repair Surgery

Michigan 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 $5,754 · 10th–90th $1,230$15,8490%20%10th90th$5,754Professionalmedian $1,072 · 10th–90th $851$2,1880%20%10th90th$1,072$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$1,230.27
Median
$5,754.40
Typical High
$15,848.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,000.00
Typical High
$2,290.87
BCBS
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$281.84
Typical High
$281.84
BCBS
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,380.38
Typical High
$1,479.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,148.15
Typical High
$2,290.87
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$4,897.79
Typical High
$15,848.93
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,071.52
Typical High
$1,995.26
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,023.29
Typical High
$1,949.84
United
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$7,585.78
Typical High
$14,791.08
United
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,096.48
Typical High
$1,584.89