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Mouthpiece

Montana rates for HCPCS A4617

Mouthpiece

Rates data updated October 2026.

How much does Mouthpiece cost?

$4.57

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $4.57 for this service. The price depends on where it is billed: about $4.57 from a physician practice, and about $5.25 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$4.57$4.07 to $5.50
FacilityA hospital or hospital-owned outpatient department$5.25$4.47 to $251

How much rates vary

Facilitymedian $5 · 10th to 90th $4 to $257Professionalmedian $5 · 10th to 90th $2 to $251
$2$5$10$20$50$100$200facility $5professional $5

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
Professional
Modifier
None
Typical Low
$1.26
Median
$3.31
Typical High
$5.89
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$4.27
Median
$4.27
Typical High
$4.27
Cigna
Setting
Facility
Modifier
None
Typical Low
$4.57
Median
$4.57
Typical High
$4.57
Cigna
Setting
Professional
Modifier
None
Typical Low
$4.57
Median
$4.57
Typical High
$4.57
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$3.31
Median
$5.50
Typical High
$257.04
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$4.47
Median
$5.50
Typical High
$269.15
Providence
Setting
Facility
Modifier
None
Typical Low
$3.09
Median
$4.57
Typical High
$5.25
Providence
Setting
Professional
Modifier
None
Typical Low
$3.39
Median
$4.57
Typical High
$79.43
United
Setting
Professional
Modifier
None
Typical Low
$1.70
Median
$1.82
Typical High
$3.09

Where Montana 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.

Montana· 2nd of 51

$4.57

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.