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Custom Fitting Of A Surgical Palate-Covering Device

New Jersey 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?

$2,801

Typical total for the visit. In New Jersey, July 2026.

Insurers have agreed to pay about $2,801 for this procedure. That total is two separate charges: $851 to the doctor who performs it, and $1,950 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$851$708 to $1,175
Facility feeThe hospital or surgery center$1,950$1,047 to $5,129

How much rates vary

Facilitymedian $1,950 · 10th to 90th $851 to $7,244Professionalmedian $851 · 10th to 90th $661 to $2,042
$1K$2K$5K$10Kfacility $1,950professional $851

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
$851.14
Median
$1,047.13
Typical High
$1,513.56
Aetna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$851.14
Typical High
$1,318.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,258.93
Typical High
$2,630.27
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,122.02
Typical High
$1,548.82
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$4,073.80
Typical High
$6,918.31
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$851.14
Typical High
$2,754.23
United
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$5,128.61
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$912.01
Typical High
$2,137.96

Where New Jersey 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

New Jersey· 23rd of 50

$2,801

$851 physician + $1,950 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.