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Rhode Island 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
$3,706.14 / $3,706.14 / $3,955.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.85 / $631.66 / $670.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$556.32 / $654.49 / $1,160.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.33 / $758.42 / $1,163.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,649.00 / $4,915.00 / $7,205.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$573.52 / $734.12 / $1,134.25