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Custom Fitting Of A Surgical Palate-Covering Device

Connecticut 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?

$5,240

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

Insurers have agreed to pay about $5,240 for this procedure. That total is two separate charges: $1,072 to the doctor who performs it, and $4,169 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$1,072$851 to $1,778
Facility feeThe hospital or surgery center$4,169$3,548 to $6,607

How much rates vary

Facilitymedian $4,169 · 10th to 90th $1,349 to $10,965Professionalmedian $1,072 · 10th to 90th $724 to $2,754
$1K$2K$5K$10Kfacility $4,169professional $1,072

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
$1,348.96
Median
$1,348.96
Typical High
$1,659.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$954.99
Typical High
$3,388.44
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$4,168.69
Typical High
$12,022.64
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,513.56
Typical High
$2,187.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$1,174.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,548.82
Typical High
$2,290.87
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,479.11
Typical High
$1,862.09
United
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$6,025.60
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,288.25
Typical High
$2,290.87

Where Connecticut 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

Connecticut· 4th of 50

$5,240

$1,072 physician + $4,169 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.