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Custom Fitting Of A Surgical Palate-Covering Device

Massachusetts 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?

$2,055

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

Insurers have agreed to pay about $2,055 for this procedure. That total is two separate charges: $1,122 to the doctor who performs it, and $933 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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,122$851 to $1,738
Facility feeThe hospital or surgery center$933$832 to $1,905

How much rates vary

Facilitymedian $933 · 10th to 90th $776 to $3,631Professionalmedian $1,122 · 10th to 90th $741 to $2,399
$100$200$500$1K$2K$5K$10Kfacility $933professional $1,122

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
$776.25
Median
$933.25
Typical High
$933.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$933.25
Typical High
$2,344.23
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$2,344.23
Typical High
$4,786.30
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$1,230.27
Typical High
$2,884.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$1,905.46
Cigna
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,318.26
Typical High
$2,398.83
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$891.25
Typical High
$3,630.78
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,258.93
Typical High
$1,778.28
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$3,630.78
Typical High
$8,511.38
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,288.25
Typical High
$2,398.83
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$2,344.23
Typical High
$4,786.30
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$1,230.27
Typical High
$2,884.03
United
Setting
Facility
Modifier
Global
Typical Low
$1,445.44
Median
$3,630.78
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,380.38
Typical High
$2,454.71

Where Massachusetts 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

Massachusetts· 39th of 50

$2,055

$1,122 physician + $933 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.