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Connecticut rates for HCPCS A4617

Mouthpiece

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.79 / $2.79 / $2.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $2.74 / $3.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.12 / $2.12 / $2.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $1.77 / $1.77
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.12 / $0.12 / $2.81
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $2.81 / $7.49
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $6.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.65 / $2.16 / $3.79