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Alaska rates for HCPCS E0439

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$753.66 / $1,809.28 / $1,809.28
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$492.35 / $816.47 / $1,248.28
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.65 / $164.65 / $164.65
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.16 / $887.34 / $1,929.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$492.35 / $816.47 / $1,248.28
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.13 / $115.92 / $202.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.40 / $81.62 / $204.05