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Arizona rates for HCPCS 42205

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $4,521.00 / $7,960.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$868.61 / $1,000.89 / $1,480.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$888.80 / $3,318.56 / $5,814.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$989.47 / $1,130.82 / $1,314.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$717.00 / $1,567.87 / $2,568.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.28 / $1,097.04 / $2,085.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$903.11 / $1,104.42 / $6,261.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$819.12 / $1,079.96 / $9,072.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,350.00 / $6,230.00 / $9,010.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$801.00 / $1,011.93 / $1,847.35