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Custom Fitting Of A Surgical Palate-Covering Device

Iowa 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?

$3,180

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

Insurers have agreed to pay about $3,180 for this procedure. That total is two separate charges: $1,230 to the doctor who performs it, and $1,950 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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,230$871 to $1,820
Facility feeThe hospital or surgery center$1,950$1,380 to $3,236

How much rates vary

Facilitymedian $1,950 · 10th to 90th $1,122 to $4,677Professionalmedian $1,230 · 10th to 90th $708 to $3,631
$1K$2K$5Kfacility $1,950professional $1,230

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
$1,122.02
Median
$1,122.02
Typical High
$1,380.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$954.99
Typical High
$4,265.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,995.26
Typical High
$2,630.27
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,096.48
Typical High
$2,398.83
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$1,949.84
Typical High
$4,466.84
Medica
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,905.46
Typical High
$6,165.95
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$1,995.26
Typical High
$2,344.23
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,949.84
Typical High
$2,344.23
United
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$3,801.89
Typical High
$5,495.41
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,318.26
Typical High
$2,398.83
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,513.56
Typical High
$1,995.26

Where Iowa 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

Iowa· 17th of 50

$3,180

$1,230 physician + $1,950 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.