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Texas rates for HCPCS 42225

Palatoplasty for cleft palate; attachment pharyngeal flap

Facilitymedian $3,631 · 10th–90th $1,023$12,3030%10%10th90th$3,631Professionalmedian $1,047 · 10th–90th $891$1,7380%20%10th90th$1,047$10.0$50.0$200.0$1.0K$5.0K$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 / $3,715.35 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,047.13 / $1,621.81
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $7,585.78 / $15,135.61
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,071.52 / $1,513.56
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $1,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,801.89 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,202.26 / $2,041.74
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $16,982.44
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,585.78 / $8,511.38 / $8,511.38
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,318.26 / $3,311.31
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,122.02 / $1,905.46
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $870.96
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $1,819.70 / $2,570.40
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,258.93 / $2,187.76
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,230.27 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $5,888.44 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,071.52 / $1,659.59
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,000.00 / $1,174.90