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Palate Lengthening With Pharyngeal Flap

Michigan 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 Michigan, July 2026.

Insurers have agreed to pay about $1,023 for this service. The price depends on where it is billed: about $1,000 from a physician practice, and about $5,754 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$1,000$891 to $1,175
FacilityA hospital or hospital-owned outpatient department$5,754$4,898 to $5,754

How much rates vary

Facilitymedian $5,754 · 10th to 90th $1,148 to $8,128Professionalmedian $1,000 · 10th to 90th $832 to $1,288
$500$1K$2K$5K$10Kfacility $5,754professional $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
$1,148.15
Median
$5,754.40
Typical High
$6,918.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$977.24
Typical High
$1,288.25
BCBS
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$812.83
Typical High
$812.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,288.25
Typical High
$1,348.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,096.48
Typical High
$2,290.87
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$2,754.23
Typical High
$5,754.40
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,000.00
Typical High
$1,318.26
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$2,290.87
Typical High
$3,801.89
United
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$7,762.47
Typical High
$14,791.08
United
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,122.02
Typical High
$1,584.89

Where Michigan 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.

Michigan· 39th 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.