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Louisiana 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
$555.89 / $2,562.00 / $4,050.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.89 / $663.19 / $723.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,051.21 / $2,355.75 / $3,159.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$647.25 / $711.94 / $848.12
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.55 / $653.64 / $854.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$385.00 / $1,309.00 / $7,168.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.49 / $725.61 / $1,087.74