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Mouthpiece

Louisiana rates for HCPCS A4617

Mouthpiece

Rates data updated July 2026.

Facilitymedian $3 · 10th–90th $2$80%20%10th90th$3Professionalmedian $3 · 10th–90th $1$40%10%10th90th$3$2.0$5.0$10.0$20.0

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
$2.45
Median
$3.09
Typical High
$3.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$2.75
Typical High
$3.80
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$2.19
Median
$4.47
Typical High
$6.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3.80
Median
$6.46
Typical High
$8.91
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.69
Median
$2.69
Typical High
$2.69
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$1.82
Typical High
$4.90
United
Setting
Facility
Modifier
Global
Typical Low
$1.26
Median
$2.00
Typical High
$2.75
United
Setting
Professional
Modifier
Global
Typical Low
$1.23
Median
$2.04
Typical High
$3.02