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Cleft Palate Repair With Gum Ridge Bone Graft

Kansas 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 $4,898 · 10th–90th $1,349$9,7720%5%10%10th90th$4,898Professionalmedian $1,514 · 10th–90th $1,000$1,8620%20%10th90th$1,514$500.0$1.0K$2.0K$5.0K$10.0K$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
$2,344.23
Median
$5,370.32
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,148.15
Typical High
$2,089.30
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$3,467.37
Typical High
$3,467.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$1,288.25
Typical High
$5,011.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,380.38
Typical High
$2,238.72
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,513.56
Typical High
$10,964.78
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,445.44
Typical High
$11,481.54
United
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$4,466.84
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,288.25
Typical High
$1,905.46