go back

Cleft Palate Repair With Gum Ridge Bone Graft

New Jersey 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 $8,511 · 10th–90th $3,802$13,4900%10%10th90th$8,511Professionalmedian $1,148 · 10th–90th $933$2,9510%10%20%10th90th$1,148$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
$4,365.16
Median
$8,511.38
Typical High
$12,302.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,122.02
Typical High
$5,888.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,348.96
Typical High
$2,691.53
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,380.38
Typical High
$1,995.26
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$19,952.62
Typical High
$30,199.52
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,258.93
Typical High
$2,511.89
United
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$8,709.64
Typical High
$18,197.01
United
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,230.27
Typical High
$2,398.83