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Rhode Island 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
$1,009.40 / $1,009.40 / $3,955.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.02 / $521.49 / $538.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.27 / $541.49 / $756.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.80 / $627.57 / $960.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,649.00 / $4,915.00 / $7,205.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.09 / $608.91 / $936.43