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Cleft Palate Repair Surgery

Nebraska 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 $7,943 · 10th–90th $1,318$15,1360%20%10th90th$7,943Professionalmedian $1,000 · 10th–90th $851$2,3990%20%40%10th90th$1,000$10.0$50.0$200.0$1.0K$5.0K$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
$4,570.88
Median
$7,943.28
Typical High
$15,135.61
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$977.24
Typical High
$2,137.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$11,748.98
Median
$15,488.17
Typical High
$30,199.52
BCBS
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,412.54
Typical High
$1,995.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$1,778.28
Typical High
$2,884.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$1,412.54
Typical High
$8,709.64
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,778.28
Typical High
$9,772.37
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$2,187.76
Typical High
$2,884.03
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,819.70
Typical High
$2,884.03
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$1,348.96
Typical High
$2,398.83
United
Setting
Facility
Modifier
Global
Typical Low
$6,309.57
Median
$7,413.10
Typical High
$9,120.11
United
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,412.54
Typical High
$2,344.23