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Palate Lengthening With Pharyngeal Flap

New Mexico 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 New Mexico, July 2026.

Insurers have agreed to pay about $1,023 for this service. The price depends on where it is billed: about $977 from a physician practice, and about $1,288 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$977$891 to $1,288
FacilityA hospital or hospital-owned outpatient department$1,288$1,023 to $1,995

How much rates vary

Facilitymedian $1,288 · 10th to 90th $891 to $3,467Professionalmedian $977 · 10th to 90th $851 to $2,042
$50$200$1K$5Kfacility $1,288professional $977

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
$1,288.25
Median
$2,089.30
Typical High
$8,709.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$977.24
Typical High
$3,715.35
Cigna
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,202.26
Typical High
$1,698.24
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,288.25
Providence
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$1,230.27
Typical High
$2,187.76
Providence
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,318.26
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$1,698.24
Median
$11,748.98
Typical High
$19,054.61
United
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,230.27
Typical High
$1,862.09

Where New Mexico 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 Mexico· 44th 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.