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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
$190.55 / $3,388.44 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $354.81 / $1,348.96
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $1,862.09 / $4,265.80
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $407.38 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $562.34 / $954.99
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $407.38 / $8,511.38
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $346.74 / $630.96
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $3,311.31 / $5,888.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $380.19 / $691.83
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $1,862.09 / $4,265.80
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $407.38 / $954.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $2,884.03 / $4,677.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $467.74 / $831.76