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Pennsylvania rates for HCPCS 33986

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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$618.66 / $5,526.00 / $13,947.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,480.74
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.00 / $5,526.00 / $13,969.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$504.00 / $504.00 / $588.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$656.00 / $2,391.00 / $6,322.00