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Custom Fitting Of A Surgical Palate-Covering Device

Oregon 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?

$3,247

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

Insurers have agreed to pay about $3,247 for this procedure. That total is two separate charges: $1,549 to the doctor who performs it, and $1,698 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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,549$1,096 to $1,862
Facility feeThe hospital or surgery center$1,698$1,288 to $1,820

How much rates vary

Facilitymedian $1,698 · 10th to 90th $1,000 to $2,239Professionalmedian $1,549 · 10th to 90th $794 to $2,291
$100$200$500$1K$2K$5Kfacility $1,698professional $1,549

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
$1,584.89
Median
$1,819.70
Typical High
$2,290.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$977.24
Typical High
$2,454.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$851.14
Cigna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,548.82
Typical High
$2,344.23
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,737.80
Typical High
$2,238.72
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$1,380.38
Typical High
$2,041.74
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,621.81
Typical High
$2,187.76
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,737.80
Typical High
$1,905.46
Providence
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$1,380.38
Typical High
$2,041.74
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$1,621.81
Typical High
$2,238.72
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$5,011.87
Typical High
$6,025.60
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,778.28
Typical High
$2,454.71
United
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$4,897.79
Typical High
$7,244.36
United
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,584.89
Typical High
$2,238.72

Where Oregon 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

Oregon· 16th of 50

$3,247

$1,549 physician + $1,698 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.