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Mouthpiece

Nebraska rates for HCPCS A4617

Mouthpiece

Rates data updated July 2026.

Facilitymedian $4 · 10th–90th $2$150%20%10th90th$4Professionalmedian $3 · 10th–90th $1$40%20%10th90th$3$2.0$5.0$10.0$20.0$50.0$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
$3.55
Median
$3.55
Typical High
$3.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$2.82
Typical High
$3.55
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$6.03
Typical High
$6.03
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$4.17
Typical High
$4.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$4.90
Typical High
$4.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$5.13
Typical High
$8.91
Medica
Setting
Facility
Modifier
Global
Typical Low
$3.09
Median
$5.37
Typical High
$89.13
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.51
Median
$2.14
Typical High
$44.67
Midlands
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$5.62
Typical High
$9.12
Midlands
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$4.90
Typical High
$4.90
Midlands
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$6.17
Typical High
$10.72
United
Setting
Facility
Modifier
Global
Typical Low
$1.51
Median
$4.47
Typical High
$4.47
United
Setting
Professional
Modifier
Global
Typical Low
$1.51
Median
$2.14
Typical High
$4.37