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Mouthpiece

Utah rates for HCPCS A4617

Mouthpiece

Rates data updated October 2026.

How much does Mouthpiece cost?

$3.09

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $3.09 for this service. Most negotiated rates run $1.82 to $3.09.

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 $1 · 10th to 90th $1 to $1Professionalmedian $3 · 10th to 90th $1 to $4
$2$5$10$20facility $1professional $3

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
Facility
Modifier
None
Typical Low
$1.38
Median
$1.38
Typical High
$1.38
Aetna
Setting
Professional
Modifier
None
Typical Low
$1.38
Median
$1.38
Typical High
$2.75
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.82
Median
$1.82
Typical High
$3.09
Molina
Setting
Professional
Modifier
None
Typical Low
$3.16
Median
$3.16
Typical High
$4.27
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$3.09
Median
$3.09
Typical High
$3.09
Select Health
Setting
Facility
Modifier
None
Typical Low
$4.47
Median
$4.47
Typical High
$4.47
Select Health
Setting
Professional
Modifier
None
Typical Low
$3.39
Median
$4.47
Typical High
$4.47
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$2.95
Median
$3.98
Typical High
$6.61
United
Setting
Professional
Modifier
None
Typical Low
$1.45
Median
$1.82
Typical High
$3.63

Where Utah 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.

Utah· 24th of 51

$3.09

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.