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Custom Fitting Of A Surgical Palate-Covering Device

Indiana 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?

$8,794

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

Insurers have agreed to pay about $8,794 for this procedure. That total is two separate charges: $851 to the doctor who performs it, and $7,943 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$851$741 to $1,096
Facility feeThe hospital or surgery center$7,943$4,898 to $9,550

How much rates vary

Facilitymedian $7,943 · 10th to 90th $1,479 to $10,471Professionalmedian $851 · 10th to 90th $676 to $1,549
$1K$2K$5K$10Kfacility $7,943professional $851

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
$812.83
Median
$1,023.29
Typical High
$1,479.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$812.83
Typical High
$1,122.02
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,265.80
Median
$8,317.64
Typical High
$10,471.29
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,288.25
Typical High
$1,949.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,174.90
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,023.29
Typical High
$1,862.09
United
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$3,467.37
Typical High
$6,456.54
United
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$977.24
Typical High
$1,659.59

Where Indiana 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

Indiana· 1st of 50

$8,794

$851 physician + $7,943 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.