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Arkansas 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
Facility
Modifier
Low / Median / High Price
$456.50 / $456.50 / $456.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.50 / $687.60 / $1,005.44
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.57 / $97.57 / $97.57
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.57 / $97.57 / $97.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.00 / $95.00 / $95.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.76 / $71.76 / $4,321.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.57 / $62.77 / $178.24