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Utah 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
$1,258.93 / $6,025.60 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,023.29 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $1,202.26 / $1,995.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,905.46
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $5,370.32 / $12,022.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,479.11 / $1,949.84
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,778.28 / $2,454.71
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,412.54 / $2,089.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,047.13 / $1,659.59