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Tennessee 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
$524.44 / $2,678.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.99 / $323.73 / $624.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.00 / $2,302.00 / $4,372.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.66 / $354.09 / $620.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.16 / $413.71 / $585.89
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $3,260.62 / $3,348.18
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,866.32 / $1,914.64 / $2,258.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,233.00 / $2,665.00 / $4,918.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.87 / $423.30 / $664.39