Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Impression and custom preparation; surgical obturator prosthesis
SAN ANTONIO, TX
See all hospitals reporting CPT 21076 →Price type
Methodist Hospital’s median price of $2.6k is 38% above the median hospital's median price ($1.9k), higher than 68% of the 1,422 hospitals reporting CPT 21076. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 42 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare mcd fee schedule · outpatient | $294 | $294 | — | — | — | $294 – $294 |
| 2 | First Health mcdstarkids fee schedule · outpatient | $300 | $300 | — | — | — | $300 – $300 |
| 3 | First Health starplus fee schedule · outpatient | $300 | $300 | — | — | — | $300 – $300 |
| 4 | Molina chip fee schedule · outpatient | $324 | $324 | — | — | — | $324 – $324 |
| 5 | Molina mcdstar fee schedule · outpatient | $324 | $324 | — | — | — | $324 – $324 |
| 6 | Molina star+plus fee schedule · outpatient | $324 | $324 | — | — | — | $324 – $324 |
| 7 | Molina starkids fee schedule · outpatient | $324 | $324 | — | — | — | $324 – $324 |
| 8 | First Health chip per diem · outpatient | $365 | $365 | — | — | — | $365 – $365 |
| 9 | First Health chipperinate per diem · outpatient | $365 | $365 | — | — | — | $365 – $365 |
| 10 | First Health mcdstar per diem · outpatient | $365 | $365 | — | — | — | $365 – $365 |
| 11 | Humana mgmcd fee schedule · outpatient | $368 | $368 | — | — | — | $368 – $368 |
| 12 | Aetna Better Health chip fee schedule · outpatient | $372 | $372 | — | — | — | $372 – $372 |
| 13 | Aetna Better Health chipepo fee schedule · outpatient | $372 | $372 | — | — | — | $372 – $372 |
| 14 | Aetna Better Health chipperinate fee schedule · outpatient | $372 | $372 | — | — | — | $372 – $372 |
| 15 | Aetna Better Health chpfc fee schedule · outpatient | $372 | $372 | — | — | — | $372 – $372 |
| 16 | Aetna Better Health star fee schedule · outpatient | $372 | $372 | — | — | — | $372 – $372 |
| 17 | Aetna Better Health star+plus fee schedule · outpatient | $372 | $372 | — | — | — | $372 – $372 |
| 18 | Aetna Better Health starkids fee schedule · outpatient | $372 | $372 | — | — | — | $372 – $372 |
| 19 | WellCare mcrhmo fee schedule · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 20 | WellCare mcrpos fee schedule · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 21 | WellCare mcrppo fee schedule · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 22 | WellCare mcrsnp fee schedule · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 23 | WellCare pffs fee schedule · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 24 | Healthcare Highways narrownetwork case rate · outpatient | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 25 | UnitedHealthcare smallgroup case rate · outpatient | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
Last updated: May 1, 2026
See Surgical obturator prosthesis fitting and preparation pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.