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Maryland 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
Professional
Modifier
Low / Median / High Price
$509.35 / $573.79 / $648.65
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.97 / $514.50 / $653.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.37 / $595.26 / $1,190.51
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.50 / $619.85 / $1,022.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$421.05 / $619.40 / $1,020.04
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.99 / $383.99 / $675.12