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Michigan 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
$1,004.88 / $1,004.88 / $1,004.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.40 / $889.50 / $1,004.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,367.09 / $2,718.14 / $5,251.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.87 / $101.54 / $130.55
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.86 / $87.75 / $197.44
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.36 / $77.36 / $77.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.99 / $24.99 / $4,321.62
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$472.10 / $472.10 / $1,004.88
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.70 / $547.63 / $3,481.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.59 / $176.99 / $238.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.30 / $103.90 / $363.50