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Kentucky 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
$200.20 / $305.05 / $8,229.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.20 / $229.37 / $296.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,212.00 / $9,015.00 / $11,253.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.33 / $216.55 / $275.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.80 / $264.66 / $305.29
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.04 / $264.66 / $378.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.50 / $233.50 / $233.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.18 / $293.81 / $529.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$599.00 / $4,298.00 / $30,001.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.08 / $326.19 / $460.92