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Iowa 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
$4,693.00 / $5,817.59 / $7,943.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$979.17 / $1,133.71 / $2,139.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,392.00 / $1,392.00 / $1,392.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,008.09 / $2,414.42 / $3,018.04
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$986.39 / $1,567.32 / $5,234.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,525.83 / $2,578.65 / $11,732.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,225.61 / $2,368.98 / $11,430.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,821.00 / $2,812.73 / $5,383.60
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,591.60 / $2,368.98 / $3,269.53
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $1,864.30 / $2,756.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,770.00 / $7,487.00 / $11,732.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,135.50 / $1,779.91 / $3,392.25
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,650.23 / $2,088.90 / $2,457.50