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Georgia 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
$4,365.16 / $5,888.44 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $213.80 / $389.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $2,884.03 / $4,786.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $316.23 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $309.03 / $501.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $229.09 / $1,862.09
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $323.59 / $323.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $3,235.94 / $8,128.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $302.00 / $489.78