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Mouthpiece

Missouri rates for HCPCS A4617

Mouthpiece

Rates data updated July 2026.

Facilitymedian $4 · 10th–90th $2$90%10%10th90th$4Professionalmedian $2 · 10th–90th $1$50%10%10th90th$2$0.2$1.0$5.0$20.0$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
$1.86
Median
$4.37
Typical High
$7.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$2.63
Typical High
$4.57
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$2.63
Median
$4.37
Typical High
$6.03
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.14
Median
$2.19
Typical High
$4.79
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.63
Median
$2.63
Typical High
$4.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.37
Median
$6.76
Typical High
$6.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$1.82
Typical High
$1.82
Medica
Setting
Facility
Modifier
Global
Typical Low
$2.40
Median
$4.37
Typical High
$9.77
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$2.14
Typical High
$44.67
United
Setting
Facility
Modifier
Global
Typical Low
$1.66
Median
$2.88
Typical High
$4.47
United
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$2.04
Typical High
$3.55