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Kansas rates for HCPCS A4617

Mouthpiece

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.78 / $4.78 / $4.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $2.31 / $4.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.17 / $2.17 / $2.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.15 / $2.27 / $2.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $2.25 / $2.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $1.77 / $6.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $3.70 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $2.16 / $44.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.24 / $2.14 / $3.06