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New Jersey rates for HCPCS 42205

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

Facilitymedian $8,511 · 10th–90th $4,467–$12,8820%10%10th90th$8,511Professionalmedian $1,072 · 10th–90th $851–$2,1880%10%20%10th90th$1,072$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $8,511.38 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,023.29 / $2,089.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,174.90 / $2,398.83
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,230.27 / $1,778.28
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $10,471.29 / $16,595.87
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,122.02 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $8,709.64 / $15,135.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,096.48 / $2,089.30