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Palate Lengthening With Pharyngeal Flap

Indiana 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?

$1,023

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $1,023 for this service. The price depends on where it is billed: about $933 from a physician practice, and about $15,136 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 5 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$933$891 to $1,148
FacilityA hospital or hospital-owned outpatient department$15,136$6,166 to $21,878

How much rates vary

Facilitymedian $15,136 · 10th to 90th $1,660 to $25,704Professionalmedian $933 · 10th to 90th $813 to $1,413
$1K$2K$5K$10K$20Kfacility $15,136professional $933

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
$977.24
Median
$4,897.79
Typical High
$16,218.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$933.25
Typical High
$1,348.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,570.88
Median
$15,488.17
Typical High
$25,703.96
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$912.01
Typical High
$1,479.11
CareSource
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$912.01
Typical High
$1,023.29
CareSource
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,445.44
Typical High
$1,905.46
Cigna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$1,122.02
Typical High
$1,905.46
United
Setting
Facility
Modifier
Global
Typical Low
$3,388.44
Median
$9,549.93
Typical High
$15,848.93
United
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,000.00
Typical High
$1,584.89

Where Indiana 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.

Indiana· 40th of 51

$1,023

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.