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Indiana 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
$501.19 / $2,344.23 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $537.03 / $812.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $8,709.64 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $676.08 / $1,023.29
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $478.63 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $676.08 / $1,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $5,754.40 / $12,022.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $616.60 / $1,000.00