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Cleft Palate Repair With Gum Ridge Bone Graft

New Hampshire 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.

How much does Cleft Palate Repair With Gum Ridge Bone Graft cost?

$1,660

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $1,660 for this service. The price depends on where it is billed: about $1,622 from a physician practice, and about $5,495 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,622$1,175 to $2,188
FacilityA hospital or hospital-owned outpatient department$5,495$3,802 to $9,120

How much rates vary

Facilitymedian $5,495 · 10th to 90th $871 to $15,849Professionalmedian $1,622 · 10th to 90th $1,047 to $2,630
$100$200$500$1K$2K$5K$10Kfacility $5,495professional $1,622

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$3,801.89
Typical High
$15,848.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,148.15
Typical High
$1,548.82
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,623.41
Typical High
$8,912.51
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$2,137.96
Typical High
$3,090.30
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$2,951.21
Typical High
$2,951.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$1,548.82
Typical High
$2,754.23
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$4,570.88
Typical High
$11,220.18
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,621.81
Typical High
$2,570.40
United
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$4,570.88
Typical High
$11,220.18
United
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,737.80
Typical High
$3,388.44
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$812.83
Typical High
$1,288.25

Where New Hampshire sits

The same service costs 2.6 times more in California than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Hampshire· 12th of 51

$1,660

CA $2,754WV $1,072

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.