go back

Hawaii 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
$687.60 / $896.80 / $1,005.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.76 / $71.76 / $5,177.79
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.92 / $189.44 / $189.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.00 / $670.00 / $670.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.57 / $80.83 / $301.42