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California rates for HCPCS 33965

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $10,471.29 / $22,908.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $223.87 / $812.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $11,220.18 / $17,782.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $426.58 / $758.58
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $100.00 / $1,862.09
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $346.74 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $239.88 / $575.44
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $177.83 / $218.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $194.98 / $389.05
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $56.23 / $2,238.72
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,548.82 / $1,548.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $263.03 / $263.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $223.87 / $316.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $239.88 / $549.54
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $588.84 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $6,165.95 / $18,620.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $234.42 / $512.86