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Custom Fitting Of A Surgical Palate-Covering Device

Nebraska 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?

$3,330

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

Insurers have agreed to pay about $3,330 for this procedure. That total is two separate charges: $1,288 to the doctor who performs it, and $2,042 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$1,288$813 to $1,820
Facility feeThe hospital or surgery center$2,042$1,175 to $3,162

How much rates vary

Facilitymedian $2,042 · 10th to 90th $813 to $4,467Professionalmedian $1,288 · 10th to 90th $661 to $3,802
$1K$2K$5K$10Kfacility $2,042professional $1,288

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
$660.69
Median
$2,041.74
Typical High
$2,041.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$1,148.15
Typical High
$4,786.30
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$4,265.80
Typical High
$8,317.64
BCBS
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,174.90
Typical High
$1,621.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$645.65
Typical High
$645.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,819.70
Typical High
$2,630.27
Medica
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,318.26
Typical High
$3,235.94
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,819.70
Typical High
$6,456.54
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$2,137.96
Typical High
$2,630.27
Midlands
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$645.65
Typical High
$645.65
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,995.26
Typical High
$2,630.27
United
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$2,344.23
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,621.81
Typical High
$2,344.23

Where Nebraska 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

Nebraska· 15th of 50

$3,330

$1,288 physician + $2,042 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.