go back

New Hampshire rates for HCPCS 33987

Artery Expos/Graft Artery Perfusion Ecmo/Ecls

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.08 / $235.68 / $235.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,769.10 / $5,299.00 / $8,600.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.67 / $385.32 / $612.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.24 / $484.40 / $598.05
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.49 / $428.58 / $739.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,448.00 / $7,448.00 / $7,448.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.87 / $416.95 / $798.39
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.08 / $177.19 / $225.51