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Mouthpiece

Illinois rates for HCPCS A4617

Mouthpiece

Rates data updated October 2026.

How much does Mouthpiece cost?

$2.45

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $2.45 for this service. The price depends on where it is billed: about $2.45 from a physician practice, and about $8.71 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2.45$1.82 to $3.31
FacilityA hospital or hospital-owned outpatient department$8.71$5.37 to $22.39

How much rates vary

Facilitymedian $9 · 10th to 90th $4 to $38Professionalmedian $2 · 10th to 90th $2 to $4
$2$5$10$20$50facility $9professional $2

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$2.04
Median
$2.45
Typical High
$4.47
Aetna
Setting
Professional
Modifier
None
Typical Low
$2.04
Median
$2.45
Typical High
$4.07
Ambetter
Setting
Professional
Modifier
None
Typical Low
$2.63
Median
$4.47
Typical High
$6.03
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$5.13
Median
$9.55
Typical High
$38.02
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$1.66
Median
$3.31
Typical High
$3.31
Cigna
Setting
Facility
Modifier
None
Typical Low
$4.90
Median
$4.90
Typical High
$4.90
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.82
Median
$1.82
Typical High
$1.82
Hally Health
Setting
Professional
Modifier
None
Typical Low
$3.89
Median
$5.50
Typical High
$10.96
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$5.62
Median
$5.62
Typical High
$5.62
Molina
Setting
Professional
Modifier
None
Typical Low
$4.47
Median
$5.50
Typical High
$6.46
United
Setting
Professional
Modifier
None
Typical Low
$1.82
Median
$2.14
Typical High
$5.25

Where Illinois sits

The same service costs 2.6 times more in Hawaii than in California. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 33rd of 51

$2.45

HI $4.79CA $1.82

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.