go back

Idaho rates for HCPCS E1390

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$801.82 / $801.82 / $801.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.15 / $846.44 / $1,479.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.60 / $750.60 / $750.60
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.08 / $784.58 / $1,479.17
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.08 / $207.80 / $245.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $127.91 / $1,292.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.85 / $105.64 / $363.50