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Mouth Impression For A Palate Plate

Arkansas rates for HCPCS 42280

A mold is taken of the upper jaw and the roof of the mouth so that a custom plate can be made to fit it exactly. Soft material is pressed against the palate and upper gums, then set and lifted out to give an accurate copy of the shape. It is the preparation step before the finished plate is made and fitted.

Rates data updated July 2026.

How much does Mouth Impression For A Palate Plate cost?

$166

Typical negotiated rate. In Arkansas, July 2026.

Insurers have agreed to pay about $166 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $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 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$158$117 to $186
FacilityA hospital or hospital-owned outpatient department$631$275 to $1,072

How much rates vary

Facilitymedian $631 · 10th to 90th $135 to $1,820Professionalmedian $158 · 10th to 90th $105 to $219
$100$200$500$1K$2Kfacility $631professional $158

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
$134.90
Median
$794.33
Typical High
$1,862.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$158.49
Typical High
$204.17
BCBS
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$630.96
BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$154.88
Typical High
$245.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$123.03
Typical High
$512.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$181.97
Typical High
$295.12
United
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$457.09
Typical High
$933.25
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$165.96
Typical High
$275.42

Where Arkansas sits

The same service costs 2.3 times more in Minnesota than in Kentucky. 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.

Arkansas· 41st of 51

$166

MN $316KY $138

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.