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Illinois rates for HCPCS 42215

Palatoplasty for cleft palate; major revision

Facilitymedian $5,012 · 10th–90th $1,148–$13,1830%5%10%10th90th$5,012Professionalmedian $832 · 10th–90th $646–$1,6980%10%20%10th90th$832$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
$1,122.02 / $4,466.84 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $776.25 / $1,380.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $8,511.38 / $12,022.64
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $870.96 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,148.15 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $954.99 / $1,584.89
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,258.93 / $4,570.88
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $891.25 / $977.24
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $5,370.32 / $12,302.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $891.25 / $1,479.11