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Missouri 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
$526.05 / $4,470.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.06 / $505.51 / $526.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $4,852.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.94 / $459.77 / $843.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.40 / $630.55 / $1,173.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $798.65 / $6,335.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$444.26 / $732.47 / $2,974.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.00 / $3,233.00 / $11,343.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$444.26 / $650.91 / $1,246.11