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Tennessee 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
$825.68 / $825.68 / $869.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.66 / $869.71 / $1,019.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $95.00 / $95.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.76 / $4,077.00 / $5,177.79
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $199.28 / $199.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.84 / $62.77 / $159.41