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Illinois rates for HCPCS 42205

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

Facilitymedian $4,169 · 10th–90th $1,148–$9,7720%5%10th90th$4,169Professionalmedian $1,096 · 10th–90th $891–$2,2910%10%20%10th90th$1,096$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
$1,122.02 / $4,073.80 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,047.13 / $1,905.46
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $4,786.30 / $16,595.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,348.96 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $831.76 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,230.27 / $2,137.96
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,698.24 / $6,606.93
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,230.27 / $1,348.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $5,248.07 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,202.26 / $2,041.74