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Throat Flap Surgery for Cleft Palate Speech

Connecticut rates for HCPCS 42225

Surgery that lifts a flap of tissue from the back wall of the throat and attaches it to the soft palate, narrowing the gap between the mouth and the nose. It is done when too much air escapes through the nose during speech, leaving it sounding very nasal after a cleft palate has been repaired. Closing that gap lets the palate seal so speech sounds clearer.

Rates data updated July 2026.

How much does Throat Flap Surgery for Cleft Palate Speech cost?

$1,175

Typical negotiated rate. In Connecticut, July 2026.

Insurers have agreed to pay about $1,175 for this service. The price depends on where it is billed: about $1,122 from a physician practice, and about $8,511 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,122$955 to $1,660
FacilityA hospital or hospital-owned outpatient department$8,511$6,761 to $12,589

How much rates vary

Facilitymedian $8,511 · 10th to 90th $4,677 to $14,125Professionalmedian $1,122 · 10th to 90th $871 to $2,455
$1K$2K$5K$10Kfacility $8,511professional $1,122

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$4,570.88
Median
$7,943.28
Typical High
$13,489.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,023.29
Typical High
$2,041.74
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$8,317.64
Median
$14,125.38
Typical High
$16,595.87
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,737.80
Typical High
$2,454.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$5,888.44
Typical High
$8,317.64
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,548.82
Typical High
$2,630.27
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,584.89
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$9,772.37
Typical High
$16,218.10
United
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,584.89
Typical High
$3,467.37

Where Connecticut sits

The same service costs 3.0 times more in California than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Connecticut· 29th of 51

$1,175

CA $2,884KY $955

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.