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Missouri 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
$1,122.02 / $4,897.79 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $575.44 / $1,202.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $512.86 / $912.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $489.78 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $707.95 / $1,258.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $1,288.25 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $741.31 / $3,311.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $2,818.38 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $707.95 / $1,202.26