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Palate Lengthening With Pharyngeal Flap

Illinois 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?

$1,148

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $1,148 for this service. The price depends on where it is billed: about $1,047 from a physician practice, and about $3,311 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 6 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$1,047$891 to $1,479
FacilityA hospital or hospital-owned outpatient department$3,311$1,622 to $6,918

How much rates vary

Facilitymedian $3,311 · 10th to 90th $1,023 to $10,000Professionalmedian $1,047 · 10th to 90th $832 to $2,344
$500$1K$2K$5K$10K$20Kfacility $3,311professional $1,047

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
$933.25
Median
$2,754.23
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,000.00
Typical High
$1,778.28
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$8,511.38
Typical High
$15,135.61
BCBS
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,148.15
Typical High
$1,513.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$831.76
Typical High
$5,623.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,174.90
Typical High
$1,949.84
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,584.89
Typical High
$7,413.10
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,122.02
Typical High
$1,230.27
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,122.02
United
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$5,248.07
Typical High
$12,302.69
United
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,148.15
Typical High
$1,905.46

Where Illinois 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.

Illinois· 26th of 51

$1,148

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.