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Virginia rates for HCPCS 42205

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

Facilitymedian $1,738 · 10th–90th $977$10,4710%10%10th90th$1,738Professionalmedian $1,122 · 10th–90th $871$1,9050%10%20%10th90th$1,122$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
$1,148.15 / $5,888.44 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,047.13 / $1,862.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,981.07 / $4,466.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,230.27 / $1,905.46
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,071.52 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,412.54 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,122.02 / $1,819.70
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,000.00 / $1,659.59
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,318.26 / $1,862.09
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,258.93 / $1,995.26
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,995.26
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,148.15 / $4,265.80
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,148.15 / $4,265.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $9,772.37 / $21,379.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,122.02 / $1,905.46