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Nebraska 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
$1,097.84 / $1,097.84 / $1,097.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.00 / $1,097.84 / $1,224.04
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.00 / $300.00 / $300.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$889.99 / $937.33 / $946.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.54 / $4,077.00 / $5,096.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.53 / $1,097.84 / $4,832.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.48 / $132.78 / $1,645.11
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.53 / $190.65 / $343.63
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.53 / $228.10 / $450.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.48 / $62.73 / $1,039.85