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South 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
$371.54 / $7,943.28 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $302.00 / $588.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $346.74 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $407.38 / $602.56
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $389.05 / $645.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $6,760.83 / $9,120.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $389.05 / $660.69