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Custom Fitting Of A Surgical Palate-Covering Device

Arkansas rates for HCPCS 21076

This is the process of taking impressions and custom-designing a prosthetic device that covers and seals an opening in the roof of the mouth, made to be placed at the time of surgery such as after removal of a tumor. It helps the patient speak, swallow, and eat normally while the surgical area heals.

Rates data updated July 2026.

How much does Custom Fitting Of A Surgical Palate-Covering Device cost?

$2,413

Typical total for the visit. In Arkansas, July 2026.

Insurers have agreed to pay about $2,413 for this procedure. That total is two separate charges: $1,000 to the doctor who performs it, and $1,413 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 4 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,000$851 to $1,175
Facility feeThe hospital or surgery center$1,413$1,175 to $1,549

How much rates vary

Facilitymedian $1,413 · 10th to 90th $1,000 to $1,995Professionalmedian $1,000 · 10th to 90th $692 to $1,349
$1K$2K$5Kfacility $1,413professional $1,000

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
$1,000.00
Median
$1,174.90
Typical High
$1,380.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,000.00
Typical High
$1,348.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,949.84
BCBS
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$933.25
Typical High
$1,230.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$2,511.89
Typical High
$2,511.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,258.93
Typical High
$1,659.59
United
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$1,584.89
Typical High
$4,365.16
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,000.00
Typical High
$1,621.81

Where Arkansas sits

The same service costs 6.8 times more in Indiana than in Delaware. 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

Arkansas· 33rd of 50

$2,413

$1,000 physician + $1,413 facility

IN $8,794DE $1,299

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.