go back

Illinois 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
$753.66 / $753.66 / $805.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$427.07 / $775.08 / $1,004.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.79 / $141.18 / $141.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $1,017.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.60 / $750.60 / $4,077.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.00 / $251.68 / $345.40
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.02 / $119.44 / $165.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.85 / $103.90 / $199.28