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Cleft Palate Repair With Gum Ridge Closure

Vermont rates for HCPCS 42205

This surgery repairs an opening in the roof of the mouth present from birth and also closes the cleft in the gum ridge using the patient's own tissue, without adding bone graft material. It is typically performed in infancy or childhood to restore normal separation between the mouth and nasal cavity.

Rates data updated July 2026.

Professionalmedian $1,023 · 10th–90th $891$1,3180%50%10th90th$1,023$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
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,023.29
Typical High
$1,047.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$1,258.93
Typical High
$2,238.72
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,258.93
Typical High
$2,511.89
United
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,380.38
Typical High
$2,398.83