go back

Custom Fitting Of A Surgical Palate-Covering Device

Louisiana 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?

$2,599

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

Insurers have agreed to pay about $2,599 for this procedure. That total is two separate charges: $977 to the doctor who performs it, and $1,622 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$977$794 to $1,288
Facility feeThe hospital or surgery center$1,622$1,096 to $3,020

How much rates vary

Facilitymedian $1,622 · 10th to 90th $871 to $5,012Professionalmedian $977 · 10th to 90th $708 to $1,549
$200$500$1K$2K$5Kfacility $1,622professional $977

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
$912.01
Median
$1,096.48
Typical High
$1,174.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$977.24
Typical High
$1,445.44
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,380.38
Median
$3,019.95
Typical High
$6,760.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,096.48
Typical High
$1,380.38
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$616.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,202.26
Typical High
$1,659.59
United
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$1,698.24
Typical High
$4,168.69
United
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$977.24
Typical High
$1,621.81

Where Louisiana 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

Louisiana· 26th of 50

$2,599

$977 physician + $1,622 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.