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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
$296.95 / $7,838.38 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.33 / $282.31 / $590.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.86 / $430.83 / $542.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $421.86
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.30 / $399.46 / $542.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,085.00 / $4,262.00 / $17,636.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.00 / $450.51 / $640.71