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Montana rates for HCPCS E1391

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$412.09 / $851.10 / $914.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.96 / $168.96 / $168.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.76 / $750.60 / $750.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.68 / $170.35 / $896.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.76 / $115.92 / $750.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.85 / $60.85 / $363.50