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Wisconsin rates for HCPCS 33954

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $912.01 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $4,570.88 / $7,079.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,318.26 / $2,089.30
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $7,413.10 / $14,454.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $3,388.44 / $9,549.93
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,096.48 / $1,905.46
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $5,754.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $6,165.95 / $19,498.45