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Custom Fitting Of A Surgical Palate-Covering Device

Tennessee 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?

$3,067

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

Insurers have agreed to pay about $3,067 for this procedure. That total is two separate charges: $977 to the doctor who performs it, and $2,089 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$977$794 to $1,288
Facility feeThe hospital or surgery center$2,089$1,445 to $2,570

How much rates vary

Facilitymedian $2,089 · 10th to 90th $933 to $3,981Professionalmedian $977 · 10th to 90th $692 to $1,862
$100$200$500$1K$2K$5Kfacility $2,089professional $977

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
$794.33
Median
$1,023.29
Typical High
$1,949.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$933.25
Typical High
$1,819.70
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$2,290.87
Typical High
$3,019.95
BCBS
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,318.26
Typical High
$1,995.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,174.90
Typical High
$1,862.09
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$4,365.16
Typical High
$4,365.16
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$6,456.54
Median
$7,413.10
Typical High
$7,413.10
United
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$2,187.76
Typical High
$3,890.45
United
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,047.13
Typical High
$1,819.70

Where Tennessee 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

Tennessee· 19th of 50

$3,067

$977 physician + $2,089 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.