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Wisconsin rates for HCPCS 42210

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

Facilitymedian $9,772 · 10th–90th $1,413$16,9820%5%10%10th90th$9,772Professionalmedian $1,318 · 10th–90th $1,000$4,4670%10%20%10th90th$1,318$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
$1,174.90 / $2,187.76 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,148.15 / $3,019.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,995.26 / $5,248.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,235.94 / $5,128.61
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,630.27 / $4,466.84
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,513.56 / $6,309.57
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,290.87 / $3,630.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,659.59 / $13,489.63
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,905.46 / $11,481.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $2,398.83 / $4,168.69
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,290.87 / $3,548.13
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $16,595.87 / $16,595.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $5,248.07 / $11,481.54
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $3,890.45
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,981.07 / $5,370.32
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,584.89 / $4,265.80