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Arizona 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
$2,041.74 / $3,890.45 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $323.59 / $1,202.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $2,691.53 / $3,981.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $275.42 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $331.13 / $478.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $1,348.96 / $4,466.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $338.84 / $630.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $2,290.87 / $5,495.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $309.03 / $512.86