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Palate Lengthening With Pharyngeal Flap

Tennessee 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 Tennessee, 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 $4,074 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$912 to $1,318
FacilityA hospital or hospital-owned outpatient department$4,074$2,455 to $6,761

How much rates vary

Facilitymedian $4,074 · 10th to 90th $1,318 to $10,233Professionalmedian $1,000 · 10th to 90th $832 to $1,950
$1K$2K$5K$10K$20Kfacility $4,074professional $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
$1,047.13
Median
$2,951.21
Typical High
$6,456.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,000.00
Typical High
$1,819.70
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,187.76
Median
$6,165.95
Typical High
$9,772.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,348.96
Typical High
$2,041.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$3,548.13
Typical High
$6,309.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,122.02
Typical High
$1,862.09
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$16,982.44
Typical High
$42,657.95
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$9,549.93
Median
$9,549.93
Typical High
$9,549.93
United
Setting
Facility
Modifier
Global
Typical Low
$2,187.76
Median
$5,370.32
Typical High
$10,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,071.52
Typical High
$1,737.80

Where Tennessee 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.

Tennessee· 34th 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.