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Custom Fitting Of A Surgical Palate-Covering Device

Arizona 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?

$2,337

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

Insurers have agreed to pay about $2,337 for this procedure. That total is two separate charges: $891 to the doctor who performs it, and $1,445 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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$891$794 to $1,175
Facility feeThe hospital or surgery center$1,445$955 to $2,239

How much rates vary

Facilitymedian $1,445 · 10th to 90th $724 to $3,388Professionalmedian $891 · 10th to 90th $676 to $1,995
$500$1K$2K$5Kfacility $1,445professional $891

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
Professional
Modifier
Global
Typical Low
$660.69
Median
$870.96
Typical High
$1,513.56
BCBS
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$1,862.09
Typical High
$3,467.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,096.48
Typical High
$2,570.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,023.29
Typical High
$1,737.80
Medica
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$1,122.02
Typical High
$3,090.30
Medica
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,230.27
Typical High
$6,456.54
United
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,905.46
Typical High
$4,677.35
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$933.25
Typical High
$1,548.82

Where Arizona 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

Arizona· 35th of 50

$2,337

$891 physician + $1,445 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.