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Missouri 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
$1,122.02 / $4,897.79 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $323.59 / $645.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $2,041.74 / $5,248.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $354.81 / $501.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $281.84 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $407.38 / $724.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $1,047.13 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $436.52 / $1,905.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $2,818.38 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $416.87 / $691.83