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Louisiana 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
$258.75 / $2,562.00 / $4,050.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.01 / $258.75 / $282.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.62 / $913.47 / $1,225.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.98 / $330.18 / $585.47
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.54 / $255.06 / $326.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$385.00 / $1,309.00 / $7,168.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.90 / $284.57 / $424.38