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New York rates for HCPCS 42215

Palatoplasty for cleft palate; major revision

Facilitymedian $6,310 · 10th–90th $1,230$14,1250%5%10th90th$6,310Professionalmedian $871 · 10th–90th $631$2,0890%10%10th90th$871$100.0$500.0$2.0K$10.0K$50.0K

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 / $5,754.40 / $15,135.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $794.33 / $1,778.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $7,762.47 / $13,803.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $691.83 / $1,380.38
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $3,467.37 / $13,489.63
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $3,090.30 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $1,000.00 / $2,511.89
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $954.99 / $2,511.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $977.24 / $1,479.11
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $933.25 / $1,479.11
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $933.25 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $5,248.07 / $12,589.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,122.02 / $6,760.83
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $831.76 / $2,951.21
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $891.25 / $1,905.46