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New Mexico 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
$407.38 / $416.87 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $323.59 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $426.58 / $512.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $389.05
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $501.19 / $1,047.13
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $398.11 / $512.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,090.30 / $5,128.61 / $19,498.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $446.68 / $588.84