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Vermont 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
Professional
Modifier
Low / Median / High Price
$363.35 / $363.35 / $363.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.24 / $432.60 / $918.89
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.24 / $432.60 / $918.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$271.20 / $410.86 / $1,127.83