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Supply Pricing Estimate
These estimates are for informational purposes only.
Supply Pricing Estimates
**DISCLAIMER** Estimated prices are given as a range and will differ depending on individual insurance policy. This is to be used for cost estimate, and for specific cost information please contact your insurance company and provide the supply code listed in table.
HCPCS Code
Description
Maximum Estimated Cost
Minimum Estimated Cost
A7038
Filters - Disposables
2
8
A7039
Filters - Reusable
5
12
A7031
Cushions - Full Face
35
60
A7032
Cushions - Nasal
13
52
A7033
Cushions - Oral
23
35
A7033
Pillows-Nasal
14
45
A7030
Masks-Full Face Mask
60
150
A7034
Masks-Nasal
38
92
A7027
Masks-Oral
88
122
A4604
Tubing-Heated
22
50
A7037
Tubing-Regular
9
33
A7035
Headgear
11
34
A7036
Chinstrap
5
13
A7046
Water Chamber
5
18
A7031
Cushions - Full Face
35
60
A7032
Cushions - Nasal
13
52
A7033
Cushions - Oral
23
35
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