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Palate Lengthening With Pharyngeal Flap

Idaho 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?

$1,349

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $1,349 for this service. The price depends on where it is billed: about $1,288 from a physician practice, and about $1,995 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,288$1,000 to $1,698
FacilityA hospital or hospital-owned outpatient department$1,995$1,259 to $5,754

How much rates vary

Facilitymedian $1,995 · 10th to 90th $955 to $12,589Professionalmedian $1,288 · 10th to 90th $891 to $2,630
$1K$2K$5K$10K$20Kfacility $1,995professional $1,288

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
$4,365.16
Median
$4,466.84
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,047.13
Typical High
$2,630.27
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$7,244.36
Typical High
$15,135.61
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,698.24
Typical High
$1,819.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$1,318.26
Typical High
$1,698.24
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,348.96
Typical High
$2,570.40
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,548.82
Typical High
$1,819.70
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$776.25
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$9,772.37
Median
$13,182.57
Typical High
$19,054.61
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,348.96
Median
$1,698.24
Typical High
$2,089.30
Select Health
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$7,762.47
Typical High
$12,589.25
Select Health
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$776.25
Typical High
$1,698.24
United
Setting
Facility
Modifier
Global
Typical Low
$10,232.93
Median
$22,387.21
Typical High
$27,542.29
United
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,258.93
Typical High
$1,819.70

Where Idaho 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.

Idaho· 13th of 51

$1,349

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.