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Simple Repair of a Salivary Duct

Illinois rates for HCPCS 42500

Repairs or reopens the small duct that carries saliva from a salivary gland into the mouth when it has been injured, blocked or narrowed. In this straightforward version the duct is opened or reconstructed directly and stitched so saliva can drain normally again. It is done to relieve painful swelling of the gland, particularly at mealtimes.

Rates data updated July 2026.

How much does Simple Repair of a Salivary Duct cost?

$1,585

Typical facility fee. In Illinois, July 2026.

Insurers have agreed to pay about $1,585 for this service. Most negotiated rates run $631 to $3,236.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1,950 · 10th to 90th $457 to $9,120Professionalmedian $692 · 10th to 90th $407 to $1,862
$100.0$500.0$2.0K$10.0Kfacility $1,950professional $692

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
$457.09
Median
$1,778.28
Typical High
$7,762.47
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,388.44
Median
$7,585.78
Typical High
$10,232.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$588.84
Typical High
$5,623.41
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$691.83
Typical High
$1,862.09
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$4,365.16
Typical High
$8,511.38

Where Illinois sits

The same service costs 28.2 times more in Indiana than in North Dakota. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $1,585 · 29th of 50
IN $12,303ND $437

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.