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Virginia 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
$331.13 / $3,630.78 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $323.59 / $467.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,090.30 / $3,981.07 / $4,466.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $331.13 / $467.74
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $323.59 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $371.54 / $616.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $288.40 / $354.81
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $380.19 / $602.56
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $389.05 / $7,413.10
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $389.05 / $7,413.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $3,467.37 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $407.38 / $616.60