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Cleft Palate Repair With Gum Ridge Bone Graft

Nevada 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 $3,981 · 10th–90th $1,148$8,1280%10%20%10th90th$3,981Professionalmedian $1,148 · 10th–90th $955$1,7780%20%10th90th$1,148$20.0$100.0$500.0$2.0K$10.0K

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
$1,148.15
Median
$3,981.07
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,122.02
Typical High
$1,659.59
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$8,128.31
Typical High
$8,128.31
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,288.25
Typical High
$1,995.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$3,090.30
Typical High
$4,265.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,258.93
Typical High
$1,905.46
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$1,096.48
Typical High
$1,548.82
Hometown Health
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$3,162.28
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44
Select Health
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$851.14
Typical High
$954.99
Select Health
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$870.96
Typical High
$1,819.70
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$3,548.13
Typical High
$10,715.19
United
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,174.90
Typical High
$1,995.26