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Maine 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
Professional
Modifier
Low / Median / High Price
$304.63 / $373.99 / $406.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.32 / $342.84 / $518.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.28 / $406.90 / $567.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.02 / $327.29 / $509.26
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.38 / $330.10 / $406.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.64 / $393.79 / $475.27