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Connecticut rates for HCPCS 42210

Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $7,079.46 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,148.15 / $3,019.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $14,125.38 / $16,595.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $2,089.30 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $4,570.88 / $7,413.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,659.59 / $2,884.03
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,621.81 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $8,709.64 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,380.38 / $3,311.31