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Montana 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

Facilitymedian $468 · 10th–90th $447–$5130%50%10th90th$468Professionalmedian $447 · 10th–90th $302–$9120%20%10th90th$447$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $363.08 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $416.87
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $467.74 / $512.86
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $467.74 / $512.86
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $416.87 / $478.63
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $257.04 / $512.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $467.74 / $1,122.02