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Louisiana 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
$380.19 / $2,691.53 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $323.59 / $436.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $1,380.38 / $1,862.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $416.87 / $489.78
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $380.19 / $501.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $1,230.27 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $389.05 / $616.60