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Arizona rates for HCPCS 33951

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,671.00 / $3,617.00 / $6,329.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.34 / $476.78 / $2,154.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,805.25 / $6,640.00 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.79 / $409.05 / $511.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$430.86 / $504.02 / $731.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$428.95 / $764.30 / $4,349.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$406.23 / $502.00 / $979.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,424.00 / $3,269.00 / $6,416.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$399.91 / $477.30 / $774.00