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New Jersey rates for HCPCS 42225

Palatoplasty for cleft palate; attachment pharyngeal flap

Facilitymedian $8,511 · 10th–90th $4,467–$12,8820%10%10th90th$8,511Professionalmedian $1,096 · 10th–90th $832–$2,2910%10%20%10th90th$1,096$100.0$500.0$2.0K$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
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
$891.25 / $1,071.52 / $2,344.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,202.26 / $2,454.71
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,380.38 / $1,995.26
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,481.54 / $18,197.01 / $30,199.52
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,148.15 / $2,187.76
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
$676.08 / $1,096.48 / $2,137.96