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Maryland rates for HCPCS 33957

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.85 / $223.79 / $249.55
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.27 / $242.60 / $376.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.12 / $232.19 / $464.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.76 / $242.21 / $398.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.70 / $226.80 / $377.84
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.15 / $186.15 / $263.83