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Maine 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
$134.90 / $234.42 / $354.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $288.40 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $275.42 / $436.52
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $281.84 / $371.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $275.42 / $354.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $295.12 / $380.19