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Nationwide rates for HCPCS 42205

Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only

Facilitymedian $5,129 · 10th–90th $1,175–$13,8040%5%10%10th90th$5,129Professionalmedian $1,122 · 10th–90th $871–$2,5120%20%10th90th$1,122$1.0$10.0$100.0$1.0K$10.0K$100.0K$1.0M

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
$1,258.93 / $5,128.61 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,023.29 / $1,905.46
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $7,943.28 / $15,848.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,096.48 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $1,819.70 / $4,677.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,258.93 / $2,630.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $6,165.95 / $14,125.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,202.26 / $2,344.23

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