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Cleft Palate Repair With Gum Ridge Bone Graft

Vermont 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 October 2026.

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

$1,622

Typical negotiated rate. In Vermont, October 2026.

Insurers have agreed to pay about $1,622 for this service. The price depends on where it is billed: about $1,549 from a physician practice, and about $6,310 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,549$1,380 to $1,622
FacilityA hospital or hospital-owned outpatient department$6,310$5,888 to $6,310

How much rates vary

Facilitymedian $6,310 · 10th to 90th $2,344 to $6,310Professionalmedian $1,549 · 10th to 90th $1,148 to $2,188
$500$1K$2K$5Kfacility $6,310professional $1,549

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$6,309.57
Median
$6,309.57
Typical High
$6,309.57
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,096.48
Median
$1,148.15
Typical High
$1,479.11
BCBS Vermont
Setting
Facility
Modifier
None
Typical Low
$5,888.44
Median
$5,888.44
Typical High
$5,888.44
BCBS Vermont
Setting
Professional
Modifier
None
Typical Low
$1,698.24
Median
$1,778.28
Typical High
$3,890.45
Cigna
Setting
Facility
Modifier
None
Typical Low
$660.69
Median
$660.69
Typical High
$6,760.83
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,380.38
Median
$1,621.81
Typical High
$1,621.81
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$1,148.15
Median
$1,445.44
Typical High
$2,818.38
United
Setting
Facility
Modifier
None
Typical Low
$2,344.23
Median
$2,344.23
Typical High
$2,344.23
United
Setting
Professional
Modifier
None
Typical Low
$1,230.27
Median
$1,548.82
Typical High
$2,238.72

Where Vermont sits

The same service costs 6.2 times more in Alaska than in Texas. 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.

Vermont· 16th of 51

$1,622

AK $4,365TX $708

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.