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Custom Fitting Of A Surgical Palate-Covering Device

Ohio 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?

$3,501

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

Insurers have agreed to pay about $3,501 for this procedure. That total is two separate charges: $871 to the doctor who performs it, and $2,630 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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$871$759 to $1,096
Facility feeThe hospital or surgery center$2,630$1,175 to $4,365

How much rates vary

Facilitymedian $2,630 · 10th to 90th $832 to $4,571Professionalmedian $871 · 10th to 90th $676 to $1,380
$50$200$1K$5Kfacility $2,630professional $871

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
$758.58
Median
$2,630.27
Typical High
$4,570.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$831.76
Typical High
$1,174.90
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$3,019.95
Typical High
$7,943.28
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$977.24
Typical High
$1,513.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$1,122.02
Typical High
$21,379.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,122.02
Typical High
$1,698.24
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$21,379.62
Median
$21,379.62
Typical High
$21,379.62
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,122.02
Typical High
$1,737.80
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$562.34
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$933.25
Typical High
$1,737.80
United
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$2,398.83
Typical High
$4,897.79
United
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$977.24
Typical High
$1,513.56

Where Ohio 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

Ohio· 14th of 50

$3,501

$871 physician + $2,630 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.