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Mouthpiece

South Dakota rates for HCPCS A4617

Mouthpiece

Rates data updated July 2026.

How much does Mouthpiece cost?

$3.63

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $3.63 for this service. The price depends on where it is billed: about $3.55 from a physician practice, and about $4.37 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3.55$2.75 to $4.90
FacilityA hospital or hospital-owned outpatient department$4.37$3.47 to $5.13

How much rates vary

Facilitymedian $4 · 10th to 90th $3 to $9Professionalmedian $4 · 10th to 90th $2 to $6
$2$5$10$20$50$100facility $4professional $4

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$3.16
Median
$3.16
Typical High
$3.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$2.95
Typical High
$3.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$4.90
Typical High
$4.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.90
Median
$4.90
Typical High
$6.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$2.95
Median
$4.37
Typical High
$9.12
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.74
Median
$2.14
Typical High
$6.03
Midlands
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$4.79
Typical High
$4.79
Midlands
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$4.90
Typical High
$4.90
Midlands
Setting
Professional
Modifier
Global
Typical Low
$3.72
Median
$3.98
Typical High
$3.98
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$3.63
Median
$4.37
Typical High
$5.75
United
Setting
Facility
Modifier
Global
Typical Low
$2.04
Median
$2.14
Typical High
$3.09
United
Setting
Professional
Modifier
Global
Typical Low
$1.51
Median
$2.34
Typical High
$4.37
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$4.17
Median
$4.17
Typical High
$4.17

Where South Dakota sits

The same service costs 2.3 times more in Minnesota than in Rhode Island. 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.

South Dakota· 4th of 51

$3.63

MN $4.37RI $1.91

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.