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Wisconsin rates for HCPCS 33952

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $812.83 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $4,570.88 / $7,079.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,174.90 / $1,905.46
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $7,413.10 / $14,454.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $3,388.44 / $9,549.93
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $977.24 / $1,698.24
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $5,128.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $6,165.95 / $19,498.45