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Custom Appliance After Lower Jaw Removal

Utah rates for HCPCS 21081

Takes impressions of the mouth and builds a custom-made appliance for someone who has had part of the lower jaw removed. The device supports the remaining jaw in a workable position and helps restore chewing, speech, and the shape of the lower face. It is made individually in a dental laboratory and fitted and adjusted over a series of visits.

Rates data updated July 2026.

How much does Custom Appliance After Lower Jaw Removal cost?

$1,995

Typical physician fee. In Utah, July 2026.

Insurers have agreed to pay about $1,995 for this service. Most negotiated rates run $1,413 to $3,162.

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 $1,995 · 10th to 90th $1,148 to $6,457
$50$200$1K$5Kprofessional $1,995

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
$1,148.15
Median
$2,398.83
Typical High
$7,244.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,949.84
Typical High
$2,691.53
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$2,818.38
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$2,238.72
Typical High
$3,801.89
Select Health
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,995.26
Typical High
$3,162.28
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$2,137.96
Typical High
$3,019.95
United
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,621.81
Typical High
$2,511.89

Where Utah sits

The same service costs 2.7 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.

Utah· 12th of 51

$1,995

AK $3,802KY $1,413

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.