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Washington, DC 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
$331.13 / $1,698.24 / $33,884.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $331.13 / $912.01
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $288.40 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $354.81 / $676.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $562.34 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $2,344.23 / $16,218.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $398.11 / $758.58