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Florida rates for HCPCS A4617

Mouthpiece

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.95 / $2.44 / $3.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $2.68 / $3.79
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.03 / $3.03 / $6.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.99 / $2.99 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $1.77 / $1.77
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $99,999.99 / $99,999.99
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $2.60 / $4.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.46 / $3.46 / $7.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $2.15 / $2.87
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.06 / $2.12 / $4.33