go back

Washington, DC rates for HCPCS A4617

Mouthpiece

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.93 / $7.33 / $7.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $2.93 / $2.93
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.80 / $2.80 / $2.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $1.77 / $5.17
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.33 / $4.33 / $8.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $2.16 / $3.59