go back

Alaska rates for HCPCS 33969

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $12,022.64 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $354.81 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $398.11 / $2,137.96
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $812.83 / $1,819.70
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,071.52 / $1,513.56
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $1,513.56 / $2,137.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $263.03 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $741.31 / $1,737.80