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West 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
$281.84 / $281.84 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $295.12 / $331.13
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $281.84 / $354.81
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $316.23 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $457.09 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $457.09 / $1,258.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $758.58 / $758.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $346.74 / $537.03