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Cleft Palate Repair With Gum Ridge Bone Graft

Mississippi 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 $1,995 · 10th–90th $891$7,9430%10%10th90th$1,995Professionalmedian $1,259 · 10th–90th $977$2,8840%20%10th90th$1,259$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
$776.25
Median
$1,000.00
Typical High
$2,884.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,258.93
Typical High
$3,019.95
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$2,951.21
Typical High
$2,951.21
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,862.09
Median
$1,862.09
Typical High
$1,862.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$2,630.27
Typical High
$6,456.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,348.96
Typical High
$2,137.96
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$4,168.69
Typical High
$10,471.29
United
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,258.93
Typical High
$2,754.23