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Custom Fitting Of A Surgical Palate-Covering Device

West Virginia 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?

$1,664

Typical total for the visit. In West Virginia, July 2026.

Insurers have agreed to pay about $1,664 for this procedure. That total is two separate charges: $832 to the doctor who performs it, and $832 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 3 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$832$708 to $1,047
Facility feeThe hospital or surgery center$832$692 to $832

How much rates vary

Facilitymedian $832 · 10th to 90th $692 to $1,122Professionalmedian $832 · 10th to 90th $631 to $1,230
$50$100$200$500$1K$2K$5Kfacility $832professional $832

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
$691.83
Median
$831.76
Typical High
$831.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$831.76
Typical High
$1,071.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$1,122.02
Typical High
$1,122.02
Cigna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,202.26
Typical High
$5,623.41
United
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$1,230.27
Typical High
$4,365.16
United
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$1,047.13
Typical High
$1,513.56

Where West Virginia 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

West Virginia· 46th of 50

$1,664

$832 physician + $832 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.