go back

Mouthpiece

Iowa rates for HCPCS A4617

Mouthpiece

Rates data updated July 2026.

Facilitymedian $4 · 10th–90th $2$100%10%10th90th$4Professionalmedian $3 · 10th–90th $1$60%10%10th90th$3$2.0$5.0$10.0$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2.57
Median
$3.16
Typical High
$3.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$2.75
Typical High
$3.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$4.90
Typical High
$4.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$4.90
Typical High
$6.03
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$4.07
Median
$8.51
Typical High
$10.47
Medica
Setting
Facility
Modifier
Global
Typical Low
$3.09
Median
$4.57
Typical High
$89.13
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$2.75
Typical High
$44.67
Midlands
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$5.13
Typical High
$5.62
Midlands
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$4.90
Typical High
$4.90
Midlands
Setting
Professional
Modifier
Global
Typical Low
$3.72
Median
$5.13
Typical High
$7.24
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$6.17
Typical High
$9.33
United
Setting
Facility
Modifier
Global
Typical Low
$1.38
Median
$2.40
Typical High
$4.47
United
Setting
Professional
Modifier
Global
Typical Low
$1.66
Median
$2.14
Typical High
$4.37
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$3.31
Median
$4.17
Typical High
$4.17