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South Dakota 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

Facilitymedian $339 · 10th–90th $269–$4,3650%20%40%10th90th$339Professionalmedian $339 · 10th–90th $263–$7080%20%10th90th$339$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $269.15 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $707.95
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $426.58 / $758.58
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $467.74 / $1,905.46
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $616.60
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $489.78 / $512.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $524.81 / $724.44
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $616.60 / $645.65