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Ohio rates for HCPCS 42200

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

Facilitymedian $6,310 · 10th–90th $1,514$11,7490%10%10th90th$6,310Professionalmedian $1,023 · 10th–90th $813$2,4550%20%10th90th$1,023$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $7,585.78 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,071.52 / $4,786.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $3,715.35 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $954.99 / $1,513.56
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $977.24 / $3,630.78
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,548.82 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,174.90 / $1,995.26
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,548.82 / $5,888.44
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $1,174.90 / $1,862.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $134.90
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $7,244.36
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,000.00 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $6,025.60 / $13,489.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,000.00 / $1,621.81