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Cleft Palate Repair With Gum Ridge Bone Graft

New Mexico 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 $1,820 · 10th–90th $1,096$17,7830%10%10th90th$1,820Professionalmedian $1,148 · 10th–90th $1,000$1,8620%20%40%10th90th$1,148$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
$1,513.56
Median
$2,089.30
Typical High
$8,709.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,096.48
Typical High
$1,659.59
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,365.16
Median
$15,488.17
Typical High
$24,547.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$3,467.37
Typical High
$3,467.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,479.11
Typical High
$2,089.30
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,548.82
Providence
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,445.44
Typical High
$2,454.71
Providence
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,548.82
Typical High
$2,511.89
United
Setting
Facility
Modifier
Global
Typical Low
$1,698.24
Median
$11,748.98
Typical High
$19,054.61
United
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,445.44
Typical High
$2,238.72