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Palate Lengthening With Pharyngeal Flap

New Jersey 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 negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $1,047 for this service. The price depends on where it is billed: about $1,000 from a physician practice, and about $8,511 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$1,000$851 to $1,380
FacilityA hospital or hospital-owned outpatient department$8,511$6,026 to $11,482

How much rates vary

Facilitymedian $8,511 · 10th to 90th $4,365 to $13,490Professionalmedian $1,000 · 10th to 90th $776 to $2,512
$1K$2K$5K$10K$20Kfacility $8,511professional $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
$4,365.16
Median
$8,511.38
Typical High
$13,489.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$954.99
Typical High
$5,888.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$1,148.15
Typical High
$2,238.72
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,202.26
Typical High
$1,737.80
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$21,379.62
Typical High
$30,199.52
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,023.29
Typical High
$2,238.72
United
Setting
Facility
Modifier
Global
Typical Low
$3,388.44
Median
$8,709.64
Typical High
$18,197.01
United
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$1,023.29
Typical High
$1,949.84

Where New Jersey 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.

New Jersey· 35th 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.