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Indiana rates for HCPCS 42225

Palatoplasty for cleft palate; attachment pharyngeal flap

Facilitymedian $15,849 · 10th–90th $1,862–$25,7040%10%10th90th$15,849Professionalmedian $1,023 · 10th–90th $871–$1,8200%20%10th90th$1,023$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
$1,071.52 / $4,897.79 / $16,218.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,023.29 / $1,905.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $19,054.61 / $27,542.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $933.25 / $1,513.56
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $977.24 / $1,122.02
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,621.81 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,230.27 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $9,549.93 / $18,197.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,047.13 / $1,659.59