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Missouri 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
$2,070.00 / $5,691.00 / $9,304.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.40 / $1,010.51 / $1,614.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,180.00 / $4,517.00 / $10,043.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$920.10 / $1,153.29 / $1,822.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,559.00 / $3,559.00 / $3,559.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$836.52 / $1,244.21 / $2,120.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.41 / $1,462.20 / $7,909.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$955.11 / $1,774.52 / $9,072.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,285.00 / $4,490.00 / $10,618.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$923.10 / $1,332.62 / $2,285.02