| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,512.77 | $10,900.00 | $14,552.94 | |
Moda Health
| Facility | $637.04 | $2,905.61 | $4,155.02 | |
Providence
| Facility | $637.04 | $2,905.61 | $4,155.02 |
Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, 6 years and older
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,512.77 | $10,900.00 | $14,552.94 | |
Moda Health
| Facility | $637.04 | $2,905.61 | $4,155.02 | |
Providence
| Facility | $637.04 | $2,905.61 | $4,155.02 |