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Georgia 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
$206.85 / $5,063.00 / $7,421.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.94 / $206.85 / $440.59
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.33 / $330.33 / $330.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$996.37 / $2,722.51 / $5,292.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.64 / $285.11 / $453.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.55 / $315.38 / $504.70
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.50 / $249.09 / $1,789.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.74 / $304.26 / $329.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,036.00 / $3,629.00 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.25 / $287.26 / $489.10