go back

North Carolina 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
$264.39 / $422.26 / $7,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.39 / $264.39 / $422.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.11 / $676.61 / $979.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$352.78 / $476.65 / $783.03
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$249.84 / $404.33 / $552.60
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$404.33 / $404.33 / $404.33
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.02 / $317.04 / $409.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,172.00 / $4,086.00 / $7,778.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.68 / $412.31 / $757.23
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $2,704.68 / $3,260.62
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,866.32 / $2,258.33 / $2,258.33