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Mouthpiece

Utah rates for HCPCS A4617

Mouthpiece

Rates data updated July 2026.

How much does Mouthpiece cost?

$2.40

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $2.40 for this service. The price depends on where it is billed: about $2.45 from a physician practice, and about $1.38 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$2.45$1.38 to $3.80
FacilityA hospital or hospital-owned outpatient department$1.38$1.38 to $1.38

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $3Professionalmedian $2 · 10th to 90th $1 to $19
$2$5$10$20facility $1professional $2

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
$1.38
Median
$1.38
Typical High
$1.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$2.09
Typical High
$18.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$1.82
Typical High
$3.55
Molina
Setting
Professional
Modifier
Global
Typical Low
$2.19
Median
$3.16
Typical High
$24.55
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$2.40
Median
$3.09
Typical High
$4.47
Select Health
Setting
Facility
Modifier
Global
Typical Low
$4.47
Median
$4.47
Typical High
$4.47
Select Health
Setting
Professional
Modifier
Global
Typical Low
$2.19
Median
$4.37
Typical High
$4.47
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$3.72
Median
$4.47
Typical High
$5.37
United
Setting
Facility
Modifier
Global
Typical Low
$1.45
Median
$2.14
Typical High
$2.88
United
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$1.82
Typical High
$3.09

Where Utah 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.

Utah· 46th of 51

$2.40

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.