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Custom Oral Surgical Splint Fitting

Maine rates for HCPCS 21085

Custom fitting and creation of a removable splint worn in the mouth after oral or jaw surgery. It is used to protect the surgical site, hold dressings or grafts in place, or support the surrounding tissue while it heals.

Rates data updated July 2026.

How much does Custom Oral Surgical Splint Fitting cost?

$724

Typical physician fee. In Maine, July 2026.

Insurers have agreed to pay about $724 for this service. Most negotiated rates run $575 to $891.

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.

How much rates vary

Professionalmedian $724 · 10th to 90th $513 to $1,202
$500$1K$2Kprofessional $724

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
$501.19
Median
$645.65
Typical High
$831.76
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$676.08
Typical High
$1,047.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$933.25
Typical High
$1,445.44
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$870.96
Typical High
$1,548.82
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$660.69
Typical High
$891.25
United
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$831.76
Typical High
$1,380.38

Where Maine sits

The same service costs 2.5 times more in California 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.

Maine· 33rd of 51

$724

CA $1,514KY $603

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.