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North Carolina rates for HCPCS 42215

Palatoplasty for cleft palate; major revision

Facilitymedian $1,096 · 10th–90th $692$12,3030%10%10th90th$1,096Professionalmedian $1,072 · 10th–90th $692$1,9500%20%10th90th$1,072$1.0$5.0$20.0$100.0$500.0$2.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $2,630.27 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $794.33 / $1,905.46
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,235.94 / $3,630.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,071.52 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $3,388.44 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $977.24 / $1,737.80
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $891.25 / $1,445.44
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $1,862.09
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $812.83 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $8,317.64 / $16,982.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $776.25 / $1,380.38
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $16,982.44 / $33,884.42
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,481.54 / $11,481.54 / $11,481.54