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Idaho 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
$4,500.00 / $4,500.00 / $5,519.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.63 / $268.41 / $616.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.57 / $347.13 / $387.55
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.54 / $329.73 / $789.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.43 / $343.04 / $392.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $309.49 / $344.86
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.37 / $403.90 / $410.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,700.00 / $15,298.00 / $26,104.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.98 / $298.89 / $446.96