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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
$1,122.02 / $4,897.79 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $251.19 / $457.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $269.15 / $426.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $213.80 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $316.23 / $549.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $616.60 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $331.13 / $1,479.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $2,818.38 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $309.03 / $524.81