go back

Wyoming 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
$418.95 / $418.95 / $418.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$947.00 / $1,068.00 / $1,282.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.55 / $640.83 / $1,010.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.00 / $1,275.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$709.50 / $1,377.21 / $1,702.82