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New York rates for HCPCS 42205

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

Facilitymedian $4,677 · 10th–90th $1,288$11,4820%5%10th90th$4,677Professionalmedian $1,175 · 10th–90th $851$2,8180%10%10th90th$1,175$100.0$500.0$2.0K$10.0K$50.0K

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
$1,230.27 / $4,677.35 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,047.13 / $2,398.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,786.30 / $9,549.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $954.99 / $1,862.09
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,630.27 / $12,302.69
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,511.89 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,380.38 / $3,467.37
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,202.26 / $3,388.44
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,318.26 / $1,995.26
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,230.27 / $2,041.74
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $1,288.25 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $5,248.07 / $12,302.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,548.82 / $8,317.64
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,148.15 / $3,890.45
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,148.15 / $2,454.71