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Illinois rates for HCPCS A4616

Tubing (Oxygen) Per Foot (Special Coverage Instructions Apply. See Cim: 60-4 And Mcm: 3312)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.05 / $0.07
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $6.00 / $6.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.62 / $1.36 / $6.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.50 / $0.50 / $0.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.38
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.17 / $0.24
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $0.10 / $0.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.11 / $0.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.04 / $0.08