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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
$236.63 / $4,771.00 / $9,539.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.24 / $236.63 / $332.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,153.00 / $7,363.00 / $9,410.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.06 / $234.34 / $326.63
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.55 / $273.48 / $533.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.24 / $275.35 / $474.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.50 / $226.20 / $278.98
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$215.31 / $270.22 / $387.74
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.00 / $293.00 / $513.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.57 / $279.27 / $3,658.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.57 / $279.27 / $3,658.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,547.00 / $3,130.00 / $5,226.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.18 / $283.61 / $451.85