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Missouri 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
$257.80 / $4,470.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.74 / $247.73 / $257.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $4,852.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.67 / $266.12 / $422.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.81 / $308.98 / $556.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $417.24 / $6,335.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.98 / $358.18 / $1,462.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.00 / $3,233.00 / $11,343.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.98 / $331.61 / $529.57