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Palate Lengthening With Pharyngeal Flap

Rhode Island 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?

$1,175

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $1,175 for this service. The price depends on where it is billed: about $1,175 from a physician practice, and about $5,370 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 4 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$1,175$977 to $1,175
FacilityA hospital or hospital-owned outpatient department$5,370$3,548 to $8,710

How much rates vary

Facilitymedian $5,370 · 10th to 90th $1,288 to $13,183Professionalmedian $1,175 · 10th to 90th $832 to $1,349
$1K$2K$5K$10Kfacility $5,370professional $1,175

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
$3,467.37
Median
$3,715.35
Typical High
$3,981.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,174.90
Typical High
$1,288.25
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,230.27
Typical High
$1,819.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$5,370.32
Typical High
$5,370.32
Cigna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,348.96
Typical High
$2,137.96
United
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$7,244.36
Typical High
$13,182.57
United
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,071.52
Typical High
$1,949.84

Where Rhode Island 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.

Rhode Island· 24th of 51

$1,175

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.