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North Dakota rates for HCPCS A4617

Mouthpiece

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.15 / $3.15 / $3.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $1.32 / $3.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.05 / $4.78 / $4.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.55 / $4.92 / $6.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $3.43 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.16 / $4.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $2.04 / $4.33