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Indiana 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
$446.68 / $2,344.23 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $478.63 / $724.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $8,709.64 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $616.60 / $912.01
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $426.58 / $457.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $660.69 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $537.03 / $912.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $5,754.40 / $12,022.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $562.34 / $891.25