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West Virginia 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
$537.71 / $537.71 / $1,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.71 / $559.75 / $625.79
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$535.47 / $614.38 / $669.37
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.00 / $595.00 / $595.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$574.54 / $574.54 / $574.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.21 / $789.40 / $2,333.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.38 / $728.13 / $1,102.48