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New Mexico 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
$602.56 / $602.56 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $794.33 / $1,000.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,234.13 / $69,183.10 / $81,283.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $75.86 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $1,000.00 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $758.58 / $758.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $151.36 / $223.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $645.65 / $1,479.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $776.25 / $776.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $93.33 / $3,388.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $109.65 / $363.08