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West Virginia 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
$496.78 / $496.78 / $1,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.78 / $515.83 / $575.97
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.26 / $567.49 / $618.29
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.60 / $549.60 / $549.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$529.46 / $529.46 / $529.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.37 / $727.44 / $2,154.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$399.94 / $641.20 / $999.04