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Maine 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
Professional
Modifier
Low / Median / High Price
$173.78 / $223.87 / $549.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $257.04 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $263.03 / $389.05
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $251.19 / $331.13
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $257.04 / $467.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $269.15 / $346.74