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Virginia 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
$549.15 / $549.15 / $896.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.15 / $753.66 / $1,004.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.20 / $700.20 / $860.96
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,055.68 / $3,055.68 / $3,055.68
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 / $83.43 / $5,177.79
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.68 / $549.15 / $1,005.44
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.77 / $189.35 / $2,732.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.05 / $173.31 / $1,816.40
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.05 / $171.60 / $1,816.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.85 / $82.06 / $190.39