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Florida rates for HCPCS 33958

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.02 / $5,839.00 / $11,576.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.49 / $176.02 / $249.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.00 / $400.00 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.09 / $243.50 / $395.17
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,460.00 / $21,065.00 / $32,051.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.37 / $138.61 / $279.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.43 / $229.86 / $291.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$677.00 / $5,417.00 / $13,093.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.80 / $243.01 / $418.38
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.88 / $137.88 / $137.88