go back

Repair Of The Front Of The Roof Of The Mouth

Illinois rates for HCPCS 42235

Closes a gap in the front part of the roof of the mouth, bringing in a flap of tissue from the partition inside the nose along with the neighbouring palate tissue to cover the opening. Closing it separates the mouth from the nasal cavity so that food and liquid stay where they belong and speech can develop normally. It is part of the surgical care of a cleft of the palate.

Rates data updated July 2026.

Facilitymedian $3,388 · 10th–90th $977$10,0000%5%10th90th$3,388Professionalmedian $851 · 10th–90th $692$1,7780%10%20%10th90th$851$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$2,754.23
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$794.33
Typical High
$1,445.44
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,265.80
Median
$8,511.38
Typical High
$12,302.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$933.25
Typical High
$1,258.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$831.76
Typical High
$5,623.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$954.99
Typical High
$1,584.89
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,288.25
Typical High
$3,801.89
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$912.01
Typical High
$1,000.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$933.25
United
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$5,248.07
Typical High
$12,302.69
United
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$933.25
Typical High
$1,548.82