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Rhode Island 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
$3,715.35 / $3,981.07 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $251.19 / $346.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $199.53 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $309.03 / $446.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $3,548.13 / $7,244.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $288.40 / $457.09