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Custom Fitting Of A Surgical Palate-Covering Device

Illinois 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?

$2,724

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

Insurers have agreed to pay about $2,724 for this procedure. That total is two separate charges: $1,175 to the doctor who performs it, and $1,549 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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,175$832 to $2,188
Facility feeThe hospital or surgery center$1,549$851 to $1,862

How much rates vary

Facilitymedian $1,549 · 10th to 90th $692 to $3,388Professionalmedian $1,175 · 10th to 90th $692 to $3,162
$1K$2K$5K$10K$20Kfacility $1,549professional $1,175

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
$691.83
Median
$912.01
Typical High
$1,819.70
Aetna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$891.25
Typical High
$1,621.81
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$2,691.53
Typical High
$29,512.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,187.76
Median
$2,511.89
Typical High
$3,162.28
Cigna
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,122.02
Typical High
$1,819.70
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,380.38
Typical High
$3,467.37
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$912.01
Typical High
$1,202.26
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$2,137.96
Typical High
$4,365.16
United
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,096.48
Typical High
$1,778.28

Where Illinois 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

Illinois· 24th of 50

$2,724

$1,175 physician + $1,549 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.