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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
$190.55 / $331.13 / $467.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $380.19 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $380.19 / $575.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $371.54 / $478.63
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $363.08 / $467.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $398.11 / $512.86