go back

Utah 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
$896.80 / $896.80 / $896.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.15 / $869.18 / $933.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.60 / $750.60 / $4,077.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $77.67 / $1,313.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.85 / $60.85 / $199.28