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New Hampshire 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
$970.54 / $970.54 / $1,164.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$714.92 / $970.54 / $1,005.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.20 / $700.20 / $1,021.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.76 / $71.76 / $83.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.67 / $77.98 / $168.64