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Mouthpiece

Virginia rates for HCPCS A4617

Mouthpiece

Rates data updated July 2026.

Facilitymedian $4 · 10th–90th $3$90%20%10th90th$4Professionalmedian $3 · 10th–90th $2$40%20%10th90th$3$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
Setting
Facility
Modifier
Global
Typical Low
$2.69
Median
$2.69
Typical High
$2.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.38
Median
$2.69
Typical High
$3.80
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.14
Median
$2.14
Typical High
$3.16
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$2.82
Median
$2.82
Typical High
$2.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6.76
Median
$6.76
Typical High
$6.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$1.82
Typical High
$1.82
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$4.47
Typical High
$6.46
Medcost
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.95
Typical High
$2.95
Medcost
Setting
Facility
Modifier
Global
Typical Low
$2.51
Median
$3.89
Typical High
$7.41
Medcost
Setting
Professional
Modifier
Global
Typical Low
$2.34
Median
$2.34
Typical High
$3.02
Sentara
Setting
Facility
Modifier
Global
Typical Low
$3.24
Median
$4.07
Typical High
$10.00
Sentara
Setting
Professional
Modifier
Global
Typical Low
$3.24
Median
$4.07
Typical High
$10.00
United
Setting
Facility
Modifier
Global
Typical Low
$1.38
Median
$1.82
Typical High
$2.88
United
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$2.14
Typical High
$3.63