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Washington 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 $646 · 10th–90th $417–$18,6210%10%20%10th90th$646Professionalmedian $363 · 10th–90th $269–$8910%10%20%10th90th$363$20.0$100.0$500.0$2.0K$10.0K

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
$489.78 / $691.83 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $338.84 / $1,071.52
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $524.81 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $524.81 / $776.25
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $562.34 / $776.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $562.34 / $776.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $501.19 / $537.03
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $537.03 / $758.58
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $524.81 / $676.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $2,454.71 / $5,754.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $436.52 / $691.83
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $331.13 / $489.78