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Idaho 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
$896.80 / $896.80 / $896.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$640.32 / $896.80 / $1,479.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.76 / $71.76 / $71.76
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.68 / $752.61 / $1,479.17
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.08 / $245.15 / $245.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $148.03 / $1,292.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.85 / $80.83 / $178.24