go back

Palate Lengthening With Pharyngeal Flap

Washington, DC rates for HCPCS 42226

Surgery that lengthens the soft palate at the back of the roof of the mouth and attaches a flap of tissue connecting it to the back of the throat. It is used to close the gap between the mouth and nose during speech, most often to correct nasal-sounding speech or air escape after a cleft palate repair or other palate problem.

Rates data updated July 2026.

How much does Palate Lengthening With Pharyngeal Flap cost?

$1,047

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $1,047 for this service. Most negotiated rates run $933 to $1,096.

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.

How much rates vary

Facilitymedian $5,495 · 10th to 90th $1,096 to $7,762Professionalmedian $1,000 · 10th to 90th $832 to $1,349
$1K$2K$5K$10K$20Kfacility $5,495professional $1,000

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
$1,096.48
Median
$4,786.30
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,000.00
Typical High
$1,096.48
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$954.99
Typical High
$5,128.61
Cigna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,122.02
Typical High
$2,511.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$933.25
Typical High
$1,819.70
United
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$13,182.57
Typical High
$34,673.69
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,071.52
Typical High
$2,187.76

Where Washington, DC sits

The same service costs 2.8 times more in California than in West Virginia. 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.

Washington, DC· 36th of 51

$1,047

CA $2,512WV $891

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.