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Tennessee 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
$1,005.47 / $2,678.00 / $7,602.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.00 / $2,326.00 / $4,936.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $9,193.60 / $9,398.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,233.00 / $2,665.00 / $4,918.00