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Custom-Made Interim Plate For A Palate Opening

South Dakota rates for HCPCS 21079

An impression is taken of the mouth and a custom plate, called an obturator, is made to seal an opening in the roof of the mouth. This one is worn during the healing phase after surgery, holding the shape of the tissues and letting the person eat, drink and speak until a long-term plate is fitted.

Rates data updated July 2026.

How much does Custom-Made Interim Plate For A Palate Opening cost?

$2,455

Typical physician fee. In South Dakota, July 2026.

Insurers have agreed to pay about $2,455 for this service. Most negotiated rates run $1,479 to $3,020.

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.

How much rates vary

Professionalmedian $2,455 · 10th to 90th $1,175 to $3,548
$1K$2K$5K$10Kprofessional $2,455

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
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,479.11
Typical High
$3,019.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,454.71
Median
$3,467.37
Typical High
$4,365.16
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$3,630.78
Typical High
$10,964.78
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,570.40
Median
$3,090.30
Typical High
$3,715.35
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,570.40
Median
$3,090.30
Typical High
$3,715.35
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$2,344.23
Typical High
$2,884.03
United
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$2,398.83
Typical High
$4,073.80
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$2,137.96
Median
$2,630.27
Typical High
$3,890.45

Where South Dakota sits

The same service costs 2.6 times more in Alaska than in Kentucky. 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.

South Dakota· 6th of 51

$2,455

AK $3,631KY $1,380

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.