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Vermont 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
$246.34 / $246.34 / $246.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.64 / $293.99 / $621.91
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.64 / $293.99 / $621.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.11 / $278.30 / $763.34