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Maine 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
$323.59 / $562.34 / $812.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $660.69 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $645.65 / $1,000.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $645.65 / $831.76
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $630.96 / $1,202.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $660.69 / $870.96