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Custom Fitting Of A Surgical Palate-Covering Device

Minnesota 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?

$4,857

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

Insurers have agreed to pay about $4,857 for this procedure. That total is two separate charges: $1,905 to the doctor who performs it, and $2,951 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$1,905$1,380 to $2,570
Facility feeThe hospital or surgery center$2,951$1,995 to $5,248

How much rates vary

Facilitymedian $2,951 · 10th to 90th $871 to $6,918Professionalmedian $1,905 · 10th to 90th $933 to $3,236
$1K$2K$5K$10Kfacility $2,951professional $1,905

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
$707.95
Median
$870.96
Typical High
$870.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$891.25
Typical High
$1,348.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$4,786.30
Typical High
$10,964.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$1,949.84
Typical High
$3,235.94
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$3,162.28
Typical High
$8,709.64
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$2,398.83
Typical High
$3,715.35
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$3,467.37
Typical High
$6,918.31
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$2,238.72
Typical High
$3,548.13
Medica
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,445.44
Typical High
$2,511.89
Medica
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,819.70
Typical High
$5,248.07
United
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$3,801.89
Typical High
$5,754.40
United
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,621.81
Typical High
$2,951.21

Where Minnesota 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

Minnesota· 7th of 50

$4,857

$1,905 physician + $2,951 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.