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Massachusetts 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
$190.87 / $2,747.00 / $5,454.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.87 / $304.63 / $1,385.59
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.59 / $1,878.00 / $4,256.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.69 / $465.89 / $1,866.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.45 / $538.41 / $956.88
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$254.95 / $404.54 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.01 / $369.68 / $660.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.22 / $616.94 / $818.58
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $2,733.00 / $5,876.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$352.36 / $526.13 / $1,866.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$953.00 / $3,325.00 / $4,662.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.22 / $449.98 / $804.36