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Cleft Palate Repair With Gum Ridge Bone Graft

Nationwide rates for HCPCS 42210

Closes a cleft in the roof of the mouth and rebuilds the gap in the gum ridge that holds the teeth, using a piece of the patient's own bone taken during the same operation. Filling the gum ridge gives the teeth a base to sit in and supports the shape of the upper jaw. It is usually done in childhood, timed around dental development.

Rates data updated July 2026.

Facilitymedian $5,888 · 10th–90th $1,230$15,4880%10%20%10th90th$5,888Professionalmedian $1,259 · 10th–90th $977$2,8840%50%10th90th$1,259$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
Facility
Modifier
Global
Typical Low
$1,230.27
Median
$5,128.61
Typical High
$13,489.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,148.15
Typical High
$2,691.53
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$9,549.93
Typical High
$17,782.79
BCBS
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,258.93
Typical High
$2,398.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$3,019.95
Typical High
$7,413.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,412.54
Typical High
$2,951.21
United
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$6,456.54
Typical High
$15,488.17
United
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,380.38
Typical High
$2,754.23