go back

Wyoming 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
Professional
Modifier
Low / Median / High Price
$992.00 / $992.36 / $1,515.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,804.00 / $3,365.00 / $5,206.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,072.02 / $1,808.50 / $2,437.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,188.00 / $5,188.00 / $18,767.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,075.52 / $1,902.00 / $3,699.79