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Tennessee 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
$1,320.47 / $2,794.39 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$874.24 / $1,112.84 / $1,716.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,678.00 / $3,744.00 / $5,737.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$875.61 / $1,231.79 / $2,012.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$728.00 / $1,754.69 / $3,203.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$877.13 / $1,210.77 / $1,950.15
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,261.43 / $7,909.30 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,072.81 / $9,072.81 / $9,072.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,485.00 / $4,937.00 / $10,111.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.90 / $1,254.71 / $2,286.56