go back

Virginia rates for HCPCS A4617

Mouthpiece

Facilitymedian $4 · 10th–90th $2–$90%20%10th90th$4Professionalmedian $2 · 10th–90th $1–$40%20%40%10th90th$2$0.2$2.0$20.0$200.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $3.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.14 / $2.14 / $3.24
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.82 / $2.82 / $2.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $6.92
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.55 / $4.47 / $6.46
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.51 / $2.95 / $2.95
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.51 / $3.89 / $7.41
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.34 / $2.34 / $3.02
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.24 / $4.07 / $10.00
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $4.07 / $10.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $1.78 / $2.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $2.14 / $3.63