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Minnesota rates for HCPCS E0434

Portable Liquid Oxygen System Rental; Includes Portable Container Supply Reservoir Humidifier Flowmeter Refill Adaptor Contents Gauge 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
$296.10 / $296.10 / $296.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.49 / $296.10 / $353.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.62 / $48.62 / $748.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$986.31 / $1,670.87 / $4,108.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$558.75 / $597.86 / $709.61
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.99 / $1,405.69 / $3,235.38
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$558.75 / $558.75 / $572.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.35 / $48.77 / $302.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.45 / $23.17 / $48.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.45 / $23.17 / $52.72