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Louisiana 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
$295.12 / $2,691.53 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $245.47 / $331.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $1,000.00 / $1,348.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $295.12 / $371.54
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $288.40 / $380.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $1,230.27 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $288.40 / $457.09