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Montana 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
Professional
Modifier
Low / Median / High Price
$521.99 / $571.90 / $2,609.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$784.49 / $784.49 / $784.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$704.27 / $784.49 / $784.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$784.49 / $784.49 / $784.49
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.22 / $704.27 / $1,052.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$774.81 / $894.01 / $1,383.79