go back

Cleft Palate Repair With Gum Ridge Bone Graft

Florida 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 $8,318 · 10th–90th $1,230$16,5960%10%10th90th$8,318Professionalmedian $1,122 · 10th–90th $891$2,0890%20%40%10th90th$1,122$50.0$200.0$1.0K$5.0K$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
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$6,760.83
Typical High
$13,803.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,122.02
Typical High
$2,137.96
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$1,949.84
AvMed
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$4,265.80
Typical High
$11,220.18
AvMed
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,096.48
Typical High
$1,258.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$2,884.03
Typical High
$3,467.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,348.96
Typical High
$2,290.87
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$12,022.64
Typical High
$23,442.29
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$954.99
Typical High
$1,288.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,318.26
United
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$9,120.11
Typical High
$15,848.93
United
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,148.15
Typical High
$2,137.96
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$1,122.02