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Cleft Palate Repair With Gum Ridge Bone Graft

Wyoming 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 $12,023 · 10th–90th $5,129$18,6210%20%40%10th90th$12,023Professionalmedian $1,514 · 10th–90th $1,000$5,2480%20%10th90th$1,514$1.0K$2.0K$5.0K$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,023.29
Typical High
$1,513.56
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,818.38
Median
$4,365.16
Typical High
$5,248.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,995.26
Typical High
$3,981.07
United
Setting
Facility
Modifier
Global
Typical Low
$5,128.61
Median
$12,022.64
Typical High
$18,620.87
United
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,905.46
Typical High
$3,715.35