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North Carolina 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
$179.35 / $289.00 / $7,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.35 / $179.35 / $289.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.00 / $499.98 / $815.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.98 / $323.08 / $529.46
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.97 / $274.18 / $374.84
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.18 / $274.18 / $274.18
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.23 / $214.38 / $277.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,172.00 / $4,086.00 / $7,778.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.49 / $308.26 / $502.75
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $1,839.64 / $2,216.50
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,267.59 / $1,537.80 / $1,537.80