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Tennessee rates for HCPCS A4617

Mouthpiece

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $2.60 / $3.79
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.68 / $3.68 / $6.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.58 / $3.90 / $4.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $1.77 / $1.77
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.85 / $90.00 / $90.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.47 / $44.16 / $45.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $2.06 / $2.88