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Major Revision of a Cleft Palate Repair

Rhode Island rates for HCPCS 42215

This surgery substantially revises an earlier cleft palate repair when the initial reconstruction did not achieve a good result, such as a persistent opening, poor healing, or ongoing speech and feeding problems. The surgeon reopens and reworks the previously repaired tissue to improve the shape, closure, and function of the palate. It is a more involved procedure than the original repair because it must work around scarred tissue from the prior surgery.

Facilitymedian $4,786 · 10th–90th $1,318$12,3030%10%10th90th$4,786Professionalmedian $759 · 10th–90th $646$1,3800%20%10th90th$759$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$4,786.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$758.58
Typical High
$1,174.90
BCBS
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$954.99
Typical High
$1,380.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$5,370.32
Typical High
$5,370.32
Cigna
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$1,047.13
Typical High
$1,659.59
United
Setting
Facility
Modifier
Global
Typical Low
$1,230.27
Median
$6,025.60
Typical High
$12,589.25
United
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$851.14
Typical High
$1,479.11