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North Carolina 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
$492.73 / $10,087.00 / $11,986.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$992.36 / $1,123.88 / $2,471.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,725.95 / $2,998.55 / $5,088.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,237.58 / $2,007.20 / $2,777.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$825.38 / $3,390.19 / $5,654.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,128.04 / $1,599.61 / $2,732.27
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,035.03 / $1,331.79 / $1,966.81
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$817.00 / $860.00 / $2,016.98
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,104.09 / $1,327.30 / $2,246.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,461.00 / $2,050.00 / $15,712.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$934.09 / $1,252.99 / $2,671.59
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,993.70 / $16,547.20 / $26,542.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,430.60 / $11,430.60 / $11,430.60