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New Jersey rates for HCPCS 42220

Palatoplasty for cleft palate; secondary lengthening procedure

Facilitymedian $8,511 · 10th–90th $4,467–$12,8820%10%10th90th$8,511Professionalmedian $646 · 10th–90th $501–$1,4130%10%20%10th90th$646$500.0$1.0K$2.0K$5.0K$10.0K$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
$4,466.84 / $8,511.38 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $616.60 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $977.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $724.44 / $1,445.44
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $776.25 / $1,122.02
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $19,054.61 / $30,199.52
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $676.08 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $8,709.64 / $15,488.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $645.65 / $1,258.93