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Tennessee 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
$813.81 / $2,678.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.00 / $497.84 / $813.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,270.00 / $2,326.00 / $4,528.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$418.15 / $549.47 / $958.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.37 / $631.04 / $905.43
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,083.43 / $5,198.71
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,906.88 / $2,974.16 / $3,529.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,233.00 / $2,665.00 / $4,918.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$404.18 / $652.80 / $1,026.18