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Custom Fitting Of A Surgical Palate-Covering Device

Missouri 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?

$4,117

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

Insurers have agreed to pay about $4,117 for this procedure. That total is two separate charges: $955 to the doctor who performs it, and $3,162 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$955$794 to $1,288
Facility feeThe hospital or surgery center$3,162$1,479 to $4,898

How much rates vary

Facilitymedian $3,162 · 10th to 90th $794 to $7,079Professionalmedian $955 · 10th to 90th $708 to $2,138
$500$1K$2K$5K$10Kfacility $3,162professional $955

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
$588.84
Median
$724.44
Typical High
$891.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$870.96
Typical High
$3,801.89
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$4,570.88
Typical High
$8,317.64
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,000.00
Typical High
$1,584.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$954.99
Typical High
$1,288.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,148.15
Typical High
$1,819.70
Medica
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$1,174.90
Typical High
$2,691.53
Medica
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,445.44
Typical High
$6,456.54
United
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,380.38
Typical High
$3,019.95
United
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,047.13
Typical High
$1,621.81

Where Missouri 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

Missouri· 11th of 50

$4,117

$955 physician + $3,162 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.