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Mouthpiece

New Hampshire rates for HCPCS A4617

Mouthpiece

Rates data updated October 2026.

How much does Mouthpiece cost?

$2.14

Typical negotiated rate. In New Hampshire, October 2026.

Insurers have agreed to pay about $2.14 for this service. Most negotiated rates run $2.14 to $2.29.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $4 · 10th to 90th $4 to $4Professionalmedian $2 · 10th to 90th $2 to $4
$2$5facility $4professional $2

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$2.09
Median
$2.29
Typical High
$2.29
Ambetter
Setting
Professional
Modifier
None
Typical Low
$5.13
Median
$5.13
Typical High
$5.13
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$2.14
Median
$2.14
Typical High
$2.14
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$0.21
Median
$0.21
Typical High
$0.21
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$1.58
Median
$1.58
Typical High
$1.58
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.82
Median
$1.82
Typical High
$1.82
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$2.14
Median
$3.80
Typical High
$3.80
United
Setting
Professional
Modifier
None
Typical Low
$1.70
Median
$2.14
Typical High
$3.55
Well Sense
Setting
Facility
Modifier
None
Typical Low
$4.37
Median
$4.37
Typical High
$4.37

Where New Hampshire 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.

New Hampshire· 45th of 51

$2.14

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.