go back

Arkansas rates for HCPCS E1390

Oxygen Concentrator Single Delivery Port Capable Of Delivering 85 Percent Or Greater Oxygen Concentration At The Prescribed Flow Rate. (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$456.50 / $456.50 / $456.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.00 / $605.71 / $995.06
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.00 / $106.00 / $106.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.57 / $639.07 / $1,086.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.57 / $668.12 / $1,141.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.86 / $750.60 / $750.60
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.30 / $94.30 / $94.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.84 / $103.99 / $455.66