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Utah 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 $4,169 · 10th–90th $447–$6,0260%20%10th90th$4,169Professionalmedian $398 · 10th–90th $263–$8130%10%10th90th$398$50.0$200.0$1.0K$5.0K

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
$446.68 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $302.00 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $407.38 / $501.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $199.53 / $1,230.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $630.96 / $660.69
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $616.60 / $870.96
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $363.08 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $4,466.84 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $389.05 / $575.44