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South Carolina 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
Facility
Modifier
Low / Median / High Price
$249.55 / $496.94 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.35 / $249.55 / $286.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.84 / $427.00 / $750.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.98 / $274.54 / $426.93
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.83 / $270.69 / $411.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.43 / $228.83 / $349.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$659.00 / $6,107.00 / $8,818.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.16 / $271.14 / $514.01