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Arizona rates for HCPCS 33987

Arterial exposure with creation of graft conduit (eg, chimney graft) to facilitate arterial perfusion for ECMO/ECLS (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,671.00 / $3,617.00 / $6,329.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.36 / $234.87 / $1,057.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,805.25 / $6,640.00 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.10 / $200.14 / $250.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.17 / $246.97 / $360.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.90 / $374.01 / $4,337.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.20 / $237.90 / $478.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,424.00 / $3,269.00 / $6,416.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.28 / $227.92 / $366.01