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Arizona rates for HCPCS 33953

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,671.00 / $3,617.00 / $6,329.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$504.60 / $533.54 / $2,402.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,805.25 / $6,640.00 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.22 / $456.30 / $570.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.48 / $562.07 / $817.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.50 / $852.60 / $4,466.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.76 / $559.72 / $1,091.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,424.00 / $3,269.00 / $6,416.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.09 / $535.08 / $880.52