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Custom Fitting Of A Surgical Palate-Covering Device

South Carolina 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?

$2,456

Typical total for the visit. In South Carolina, July 2026.

Insurers have agreed to pay about $2,456 for this procedure. That total is two separate charges: $871 to the doctor who performs it, and $1,585 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$871$794 to $1,122
Facility feeThe hospital or surgery center$1,585$1,000 to $5,495

How much rates vary

Facilitymedian $1,585 · 10th to 90th $813 to $9,333Professionalmedian $871 · 10th to 90th $692 to $1,820
$500$1K$2K$5K$10Kfacility $1,585professional $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
$812.83
Median
$1,000.00
Typical High
$2,630.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$870.96
Typical High
$1,819.70
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,388.44
Median
$7,413.10
Typical High
$10,964.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$933.25
Typical High
$1,819.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,258.93
Typical High
$1,862.09
Medcost
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$1,202.26
Typical High
$1,905.46
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,230.27
Median
$6,309.57
Typical High
$10,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$954.99
Typical High
$1,584.89

Where South Carolina 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

South Carolina· 30th of 50

$2,456

$871 physician + $1,585 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.