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Palate Lengthening With Pharyngeal Flap

Virginia 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?

$1,072

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $1,072 for this service. The price depends on where it is billed: about $1,023 from a physician practice, and about $1,585 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 8 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$1,023$912 to $1,288
FacilityA hospital or hospital-owned outpatient department$1,585$1,072 to $5,888

How much rates vary

Facilitymedian $1,585 · 10th to 90th $912 to $10,471Professionalmedian $1,023 · 10th to 90th $851 to $1,778
$1K$2K$5K$10K$20Kfacility $1,585professional $1,023

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
$1,096.48
Median
$5,888.44
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,000.00
Typical High
$1,737.80
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,606.93
Median
$7,413.10
Typical High
$9,332.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,148.15
Typical High
$1,778.28
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$954.99
Typical High
$2,691.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$2,951.21
Typical High
$3,890.45
Cigna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,071.52
Typical High
$1,698.24
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$977.24
Typical High
$1,621.81
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,230.27
Typical High
$2,041.74
Medcost
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,202.26
Typical High
$1,949.84
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,584.89
Sentara
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,122.02
Typical High
$3,801.89
Sentara
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,122.02
Typical High
$3,801.89
United
Setting
Facility
Modifier
Global
Typical Low
$2,187.76
Median
$10,000.00
Typical High
$21,877.62
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,096.48
Typical High
$1,778.28

Where Virginia 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.

Virginia· 32nd of 51

$1,072

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.