go back

West Virginia rates for HCPCS 42210

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,065.84 / $1,400.00 / $2,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$986.30 / $1,065.84 / $1,313.84
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,049.83 / $1,131.88 / $1,372.57
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$625.91 / $1,220.06 / $1,220.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,210.81 / $1,210.81 / $1,210.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.71 / $1,449.55 / $2,724.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$828.79 / $1,215.56 / $1,768.08