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Rhode Island 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
$3,715.35 / $3,981.07 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $331.13 / $457.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $263.03 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $398.11 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $3,548.13 / $7,244.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $398.11 / $602.56