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Minnesota 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 / $795.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.66 / $795.00 / $1,004.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$160.51 / $160.51 / $2,276.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,993.31 / $3,376.79 / $8,304.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,077.00 / $4,240.08 / $5,177.79
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,721.86 / $2,840.87 / $6,538.63
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,628.53 / $4,077.00 / $4,077.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.68 / $98.47 / $889.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.58 / $60.85 / $138.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.58 / $60.85 / $138.44