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Cleft Palate Repair Surgery

Utah 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 $6,457 · 10th–90th $3,162$11,2200%10%10th90th$6,457Professionalmedian $1,000 · 10th–90th $832$2,4550%20%10th90th$1,000$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
$3,162.28
Median
$6,025.60
Typical High
$9,332.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$977.24
Typical High
$2,691.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$1,148.15
Typical High
$1,949.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,819.70
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$8,511.38
Median
$11,481.54
Typical High
$17,782.79
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,412.54
Typical High
$1,862.09
Select Health
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,698.24
Typical High
$2,344.23
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,348.96
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$5,128.61
Typical High
$13,803.84
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,000.00
Typical High
$1,621.81