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Oklahoma 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
$256.02 / $256.02 / $256.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.10 / $256.02 / $349.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.82 / $42.67 / $42.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.81 / $66.81 / $66.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.70 / $80.00 / $336.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.45 / $21.03 / $32.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.45 / $23.15 / $31.79