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Fitting Of A Pin-Retained Palate Plate

North Carolina rates for HCPCS 42281

A custom-made plate for the roof of the mouth is put in place and held with small pins so it stays firmly seated. The plate covers an opening or a missing section of the palate, separating the mouth from the nose so eating and speech work normally. This step is the placement of the finished device.

Rates data updated July 2026.

How much does Fitting Of A Pin-Retained Palate Plate cost?

$533

Typical total for the visit. In North Carolina, July 2026.

Insurers have agreed to pay about $533 for this procedure. That total is two separate charges: $282 to the doctor who performs it, and $251 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$282$214 to $389
Facility feeThe hospital or surgery center$251$204 to $380

How much rates vary

Facilitymedian $251 · 10th to 90th $158 to $1,380Professionalmedian $282 · 10th to 90th $162 to $575
$200$500$1K$2K$5Kfacility $251professional $282

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
$213.80
Median
$776.25
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$218.78
Typical High
$446.68
BCBS
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$302.00
Typical High
$588.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$3,019.95
Typical High
$5,370.32
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$257.04
Typical High
$489.78
Medcost
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Medcost
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$234.42
Typical High
$380.19
Medcost
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$575.44
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$2,398.83
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$204.17
Typical High
$354.81
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$16,982.44
Typical High
$16,982.44
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$1,862.09

Where North Carolina sits

The same service costs 39.7 times more in Indiana than in Maryland. 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.

Physician feeFacility fee

North Carolina· 45th of 50

$533

$282 physician + $251 facility

IN $15,345MD $386

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.