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Washington rates for HCPCS 42210

Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)

Facilitymedian $3,020 · 10th–90th $1,380–$23,4420%10%10th90th$3,020Professionalmedian $1,445 · 10th–90th $1,000–$3,1620%20%10th90th$1,445$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $13,489.63 / $28,183.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,230.27 / $3,388.44
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,715.19 / $15,488.17 / $31,622.78
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,041.74 / $2,754.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,258.93 / $8,317.64
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,659.59 / $3,235.94
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,238.72 / $7,079.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,905.46 / $3,981.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $478.63
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,089.30 / $2,187.76
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,479.11 / $5,888.44
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,089.30 / $3,090.30
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,715.19 / $16,218.10 / $31,622.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,089.30 / $2,691.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $16,982.44 / $33,113.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,513.56 / $2,754.23
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,122.02 / $2,041.74