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South Dakota 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
$523.11 / $523.11 / $523.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.93 / $817.32 / $1,372.22
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$994.75 / $1,224.08 / $1,597.63
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.19 / $874.36 / $996.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00