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Indiana 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
$288.40 / $2,344.23 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $302.00 / $467.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $8,709.64 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $407.38 / $602.56
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $275.42 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $426.58 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $346.74 / $602.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $5,754.40 / $12,022.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $363.08 / $588.84