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Palate Lengthening With Pharyngeal Flap

West 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?

$891

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $891 for this service. The price depends on where it is billed: about $891 from a physician practice, and about $933 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$891$871 to $1,096
FacilityA hospital or hospital-owned outpatient department$933$871 to $1,445

How much rates vary

Facilitymedian $933 · 10th to 90th $871 to $2,630Professionalmedian $891 · 10th to 90th $776 to $1,230
$1K$2K$5K$10Kfacility $933professional $891

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
$870.96
Median
$870.96
Typical High
$2,630.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$891.25
Typical High
$1,148.15
CareSource
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$933.25
Typical High
$1,122.02
CareSource
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,230.27
Typical High
$7,762.47
United
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$3,548.13
Typical High
$16,595.87
United
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$954.99
Typical High
$1,584.89

Where West 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.

West Virginia· 51st of 51

$891

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.