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Iowa 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
$795.00 / $795.00 / $914.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.40 / $825.68 / $1,097.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.00 / $95.00 / $95.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.63 / $5,096.25 / $7,020.74
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.19 / $330.03 / $368.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $223.53 / $1,885.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.73 / $89.28 / $232.87
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.65 / $190.65 / $450.63
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.53 / $228.10 / $450.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.73 / $79.23 / $175.79