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Illinois rates for HCPCS E0424

Stationary Compressed Gaseous Oxygen System Rental; Includes Container Contents Regulator Flowmeter Humidifier Nebulizer Cannula Or Mask And Tubing (Special Coverage Instructions Apply. See Cim: 60-4 And Mcm: 4107.9)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$753.66 / $753.66 / $753.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.35 / $775.08 / $1,005.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.65 / $127.64 / $127.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,045.06 / $1,045.06 / $1,045.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.99 / $24.99 / $4,077.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.00 / $251.68 / $345.40
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.85 / $77.98 / $228.80