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Ohio 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
$461.74 / $4,723.00 / $11,627.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.74 / $461.74 / $1,428.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,145.00 / $2,786.00 / $8,800.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.59 / $434.97 / $667.57
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.96 / $403.96 / $588.20
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.63 / $435.63 / $468.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$381.07 / $591.54 / $909.11
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$418.38 / $596.29 / $902.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.54 / $468.49 / $623.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,480.00 / $3,086.00 / $6,792.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.34 / $582.53 / $893.57