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Vermont 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
Professional
Modifier
Low / Median / High Price
$160.94 / $215.55 / $323.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.81 / $66.81 / $592.28
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.81 / $66.81 / $709.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.45 / $28.77 / $104.90