go back

Wisconsin rates for HCPCS 42200

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

Facilitymedian $10,000 · 10th–90th $1,549$16,9820%5%10%10th90th$10,000Professionalmedian $1,148 · 10th–90th $851$3,5480%10%10th90th$1,148$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
$1,023.29 / $1,905.46 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,000.00 / $2,570.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,737.80 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,818.38 / $4,466.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $2,290.87 / $3,801.89
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,288.25 / $6,606.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,995.26 / $2,884.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,412.54 / $13,489.63
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,584.89 / $9,772.37
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,949.84 / $3,548.13
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,995.26 / $3,090.30
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $16,595.87 / $16,595.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $4,570.88 / $9,772.37
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $3,311.31
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,311.31 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,348.96 / $3,801.89