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South 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
$251.19 / $7,943.28 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $204.17 / $380.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $234.42 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $275.42 / $407.38
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $263.03 / $436.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $6,760.83 / $9,120.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $263.03 / $446.68