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Arizona rates for HCPCS 33985

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,671.00 / $3,617.00 / $6,329.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.99 / $571.90 / $2,609.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$903.06 / $3,321.60 / $5,432.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.78 / $494.38 / $617.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.94 / $622.41 / $900.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$518.44 / $945.17 / $4,466.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.70 / $608.39 / $1,185.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,424.00 / $3,269.00 / $6,416.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.70 / $592.38 / $986.10