go back

Cleft Palate Repair With Gum Ridge Bone Graft

Illinois 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 $3,162 · 10th–90th $1,072$10,0000%10%10th90th$3,162Professionalmedian $1,230 · 10th–90th $977$2,3990%20%40%10th90th$1,230$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$1,023.29
Median
$2,344.23
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,148.15
Typical High
$2,187.76
BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$8,511.38
Typical High
$18,620.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,412.54
Typical High
$1,819.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$831.76
Typical High
$5,623.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,412.54
Typical High
$2,398.83
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,905.46
Typical High
$7,943.28
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1,258.93
Median
$1,348.96
Typical High
$1,513.56
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,380.38
United
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$5,248.07
Typical High
$12,302.69
United
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,412.54
Typical High
$2,344.23