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Palate Lengthening With Pharyngeal Flap

Texas 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?

$1,096

Typical negotiated rate. In Texas, July 2026.

Insurers have agreed to pay about $1,096 for this service. The price depends on where it is billed: about $1,000 from a physician practice, and about $3,631 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 11 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 $1,288
FacilityA hospital or hospital-owned outpatient department$3,631$1,259 to $6,761

How much rates vary

Facilitymedian $3,631 · 10th to 90th $955 to $12,882Professionalmedian $1,000 · 10th to 90th $832 to $1,585
$1K$2K$5K$10K$20Kfacility $3,631professional $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
$1,000.00
Median
$3,715.35
Typical High
$12,882.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$977.24
Typical High
$1,412.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,265.80
Median
$7,762.47
Typical High
$14,791.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,047.13
Typical High
$1,412.54
Christus
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$851.14
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$3,801.89
Typical High
$4,168.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,122.02
Typical High
$1,905.46
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$42,657.95
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
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$1,174.90
Typical High
$2,041.74
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,258.93
Typical High
$1,819.70
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$758.58
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$912.01
Providence
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$1,174.90
Typical High
$2,089.30
Providence
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$1,148.15
Typical High
$2,089.30
United
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$5,754.40
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,000.00
Typical High
$1,548.82
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$812.83
Typical High
$1,122.02

Where Texas 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.

Texas· 28th of 51

$1,096

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.