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Virginia rates for HCPCS 42225

Palatoplasty for cleft palate; attachment pharyngeal flap

Facilitymedian $1,738 · 10th–90th $977$10,9650%10%10th90th$1,738Professionalmedian $1,122 · 10th–90th $891$1,9500%10%20%10th90th$1,122$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
$1,174.90 / $5,888.44 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,047.13 / $1,819.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $7,413.10 / $9,332.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,258.93 / $1,949.84
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,096.48 / $9,772.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $2,951.21 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,122.02 / $1,819.70
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,148.15 / $1,905.46
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,318.26 / $1,949.84
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,288.25 / $2,041.74
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,548.82
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,174.90 / $4,265.80
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,174.90 / $4,265.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $10,000.00 / $21,379.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,174.90 / $1,905.46