go back

Wyoming 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
$182.65 / $182.65 / $182.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$412.00 / $465.00 / $558.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.64 / $285.72 / $440.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.00 / $1,275.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.32 / $599.66 / $761.65