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Virginia 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
$251.19 / $3,630.78 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $245.47 / $354.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $7,413.10 / $9,332.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $251.19 / $354.81
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $251.19 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $275.42 / $478.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $218.78 / $269.15
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $478.63 / $478.63
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $281.84 / $467.74
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $288.40 / $7,413.10
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $288.40 / $7,413.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $3,467.37 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $295.12 / $467.74