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Texas rates for HCPCS 42205

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

Facilitymedian $3,467 · 10th–90th $1,000$12,0230%10%10th90th$3,467Professionalmedian $1,047 · 10th–90th $871$1,6980%20%10th90th$1,047$10.0$50.0$200.0$1.0K$5.0K$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
$1,071.52 / $3,890.45 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,023.29 / $1,621.81
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,365.16 / $8,128.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,047.13 / $1,479.11
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,905.46 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,202.26 / $1,995.26
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $42,657.95 / $42,657.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,332.54 / $9,332.54 / $9,332.54
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,258.93 / $3,235.94
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,096.48 / $1,862.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $870.96
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $1,778.28 / $2,454.71
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,230.27 / $2,187.76
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,230.27 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $5,623.41 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,047.13 / $1,621.81
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $891.25 / $1,047.13