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Cleft Palate Repair With Gum Ridge Bone Graft

Delaware 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 $3,311 · 10th–90th $1,660$7,2440%20%10th90th$3,311Professionalmedian $1,148 · 10th–90th $977$1,6600%20%10th90th$1,148$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$6,606.93
Median
$6,606.93
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,122.02
Typical High
$1,659.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$3,235.94
Typical High
$3,311.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,258.93
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$1,659.59
Typical High
$2,511.89
United
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,148.15
Typical High
$1,862.09