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Simple Repair of a Salivary Duct

South Carolina 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.

Facilitymedian $724 · 10th–90th $407$11,4820%5%10%10th90th$724Professionalmedian $562 · 10th–90th $525$6310%20%10th90th$562$500.0$1.0K$2.0K$5.0K$10.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$8,709.64
Typical High
$16,595.87
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$5,128.61
Typical High
$10,232.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$588.84
Typical High
$3,801.89
Medcost
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$562.34
Typical High
$630.96
Medcost
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$524.81
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$10,232.93
Typical High
$17,378.01