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Maryland 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
Professional
Modifier
Low / Median / High Price
$234.81 / $252.10 / $281.39
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.55 / $273.48 / $347.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.21 / $255.78 / $523.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.53 / $271.58 / $450.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.18 / $236.25 / $425.52
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.53 / $210.53 / $296.06