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Maine rates for HCPCS 42205

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

Facilitymedian $977 · 10th–90th $977–$6,7610%20%40%90th$977Professionalmedian $1,148 · 10th–90th $912–$2,2910%10%10th90th$1,148$500.0$1.0K$2.0K$5.0K$10.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,122.02 / $1,905.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,479.11 / $2,290.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $977.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,258.93 / $2,238.72
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,412.54 / $2,511.89
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,122.02 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $6,760.83 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,348.96 / $2,570.40