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Maine 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
Professional
Modifier
Low / Median / High Price
$288.40 / $501.19 / $724.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $588.84 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $575.44 / $891.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $575.44 / $758.58
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $562.34 / $724.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $602.56 / $776.25